Kristine Nicole Guevara, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60923877 Issued in WA

Practice address

5102 26TH St E
Fife, WA 98424-2104

Phone

(253) 330-7179

NPI assigned

Jan 22, 2018

Last updated

Dec 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristine Nicole Maniulit Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1912415175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2083",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983542083",
            "telephone_number": "253-330-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 26TH ST E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242104",
            "telephone_number": "253-330-7179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5410 N 44th St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984073715",
            "country_code": "US",
            "telephone_number": "253-759-9544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "KRISTINE",
        "middle_name": "NICOLE",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60923877",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristine@calmwatersmhc.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5102 26th St E",
            "city": "Fife",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984242104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "MANIULIT",
            "middle_name": "NICOLE",
            "credential": "BA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Fife, WA
• Providers in Fife, 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 Dec 30, 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.