Individual provider Active NPI

Kimberly Ann Crandall

  • Mental Health Counselor
  • Dallas, TX
National Provider Identifier
1902338908
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
63753 Issued in TX
Practice address
8035 E R L Thornton Fwy
Ste 432
Dallas, TX 75228-7018
Phone
(972) 339-0333
NPI assigned
Mar 29, 2017
Last updated
Mar 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 63753 TX Primary

Addresses

Primary practice location

8035 E R L Thornton Fwy
Ste 432
Dallas, TX 75228-7018

Mailing address

8035 E R L Thornton Fwy
Ste 432
Dallas, TX 75228-7018
Phone (972) 339-0333

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63753TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihearu Mental Health LLC CurrentSince Jun 12, 2024 Accepting new patients
Institute for Health Evaluation and Research Unlimited LLC CurrentSince Jun 12, 2024 Accepting new patients
Collin County Mental Health Mental Retardation Center Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Love Bond Community Outreach Past Accepting new patients

Locations

1515 Heritage Dr
Ste 105
McKinney, TX 75069
Phone (972) 562-0331

7308 Alma Dr
Plano, TX 75025
Phone (972) 422-5939

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1902338908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8035 E R L THORNTON FWY",
            "address_2": "STE 432",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752287018",
            "telephone_number": "972-339-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8035 E R L THORNTON FWY",
            "address_2": "STE 432",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752287018",
            "telephone_number": "972-339-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.