Kristine Elin Nystrom, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3385 Issued in OR

Practice address

1106 Harris Ave Ste 210
Bellingham, WA 98225-7001

Phone

(503) 382-9654

NPI assigned

Apr 2, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1891113361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1444",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982271444",
            "telephone_number": "503-382-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 HARRIS AVE STE 210",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257001",
            "telephone_number": "503-382-9654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4531 SE Belmont St",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972151675",
            "country_code": "US",
            "telephone_number": "503-382-9654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYSTROM",
        "first_name": "KRISTINE",
        "middle_name": "ELIN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500676787",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire M Nusbaum, CO61521477
• Ronald F Nussli, LMHC
• NW Medical Psychology, Inc. PS
• NW Therapy Solutions PLLC
• Elizabeth Nyblade, PH.D.
• Elissa Noel O Grady, LMP
• Kimberly S O'Brien, LMHC
• Mallory Enola O'Brien
• Michelle O'Brien, RN
• Sharon L O'Connell

• Mental Health Counselor in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.