Individual provider Active NPI

Kristy Landine, LMHC

  • Mental Health Counselor
  • Fitchburg, MA
National Provider Identifier
1871068064
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10000723 Issued in MA
Practice address
49 Nursery LN
Fitchburg, MA 01420-3576
Phone
(978) 516-5051
Fax
(978) 477-8368
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 10000723 MA Primary

Addresses

Primary practice location

49 Nursery LN
Fitchburg, MA 01420-3576

Mailing address

49 Nursery LN
Fitchburg, MA 01420-3576
Phone (978) 516-5051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216002227 MA Practitioner - Mental Health Counselor 1456795574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Making Opportunity Count, Inc.Group PAC ID 6608881354, 8 clinicians

Practice addresses (Care Compare)

49 Nursery LN
Suite 201
Fitchburg, MA 01420-3576
Phone (978) 345-7040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10000723MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Making Opportunity Count, Inc. CurrentSince Jan 3, 2024 Accepting new patients
Making Opportunity Count Inc. CurrentSince Jan 3, 2024 Accepting new patients
Luk Crisis Center Inc. PastSince Jan 9, 2013 Accepting new patients

Locations

49 Nursery Ln
Ste 201
Fitchburg, MA 01420
Phone (978) 345-7040

49 Nursery Ln
Fitchburg, MA 01420
Phone (978) 785-5302

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/luk/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1871068064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 NURSERY LN",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014203576",
            "telephone_number": "978-516-5051",
            "fax_number": "978-477-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 NURSERY LN",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014203576",
            "telephone_number": "978-516-5051",
            "fax_number": "978-477-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDINE",
        "first_name": "KRISTY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10000723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, MA

Sources for this page

Verify at the official NPI Registry.