Individual provider Active NPI

Kristen Elizabeth Persilver

  • Professional Counselor
  • Ennis, TX
National Provider Identifier
1902663016
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
88927 Issued in TX
Practice address
107 S Dallas St
Ennis, TX 75119-4786
Phone
(430) 236-2552
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 88927 TX Primary

Addresses

Primary practice location

107 S Dallas St
Ennis, TX 75119-4786

Mailing address

519 Waterboard Dr
Trinidad, TX 75163-9606
Phone (430) 236-2552

Other names 1

  • Kristen Campbell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240625003249 TX Practitioner - Mental Health Counselor 5294278784 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88927TXMDProfessional Counselor

Organizations & group practices 2

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": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1902663016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 WATERBOARD DR",
            "city": "TRINIDAD",
            "state": "TX",
            "postal_code": "751639606",
            "telephone_number": "430-236-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S DALLAS ST",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751194786",
            "telephone_number": "430-236-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSILVER",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "CAMPBELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ennis, TX

Sources for this page

Verify at the official NPI Registry.