Active NPI
Kimberly Ann Crandall
- Mental Health Counselor
- Dallas, TX
National Provider Identifier
1902338908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 63753
- 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, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63753 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihearu Mental Health LLC | Current | Accepting new patients | |
| Institute for Health Evaluation and Research Unlimited LLC | Current | Accepting new patients | |
| Collin County Mental Health Mental Retardation Center | Mental Health | Current | 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.
-
dba LifePath Systems
- Mental Health Counselor
- McKinney, TX
- NPI 1871576835
-
- Counseling Psychologist
- Mansfield, TX
- NPI 1134807100
-
dba Circulus Diagnostics
- Clinical Medical Laboratory
- Grand Prairie, TX
- NPI 1841936168
-
- Community/Behavioral Health Agency
- Dallas, TX
- NPI 1730545609
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.