Active NPI
Kendra C Crookston, PCC, NCC
- Professional Counselor
- Akron, OH
National Provider Identifier
1891940144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.0501018
- Practice address
- 1 Perkins SQ
Akron, OH 44308-1063 - Phone
- (330) 543-7472
- Fax
- (330) 543-7474
- NPI assigned
- Nov 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.0501018 | OH | Primary |
Addresses
Primary practice location
1 Perkins SQ
Akron, OH 44308-1063
Mailing address
1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-7472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.0501018 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silver Lake Psychiatry, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Stow, OH
- NPI 1295304723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227830400000",
"number": "1891940144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PERKINS SQ",
"city": "AKRON",
"state": "OH",
"postal_code": "443081063",
"telephone_number": "330-543-7472",
"fax_number": "330-543-7474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PERKINS SQ",
"city": "AKRON",
"state": "OH",
"postal_code": "443081063",
"telephone_number": "330-543-7472",
"fax_number": "330-543-7474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROOKSTON",
"first_name": "KENDRA",
"middle_name": "C",
"credential": "PCC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-28",
"last_updated": "2008-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.0501018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.