Kristen Victoria Ruth Respass

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10355 Issued in SC

Practice address

800 Legion St
Conway, SC 29526-4825

Phone

(843) 516-0455

Fax

(843) 962-5277

NPI assigned

Apr 18, 2025

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 identifiers 1

Other names 1

• Kristen Victoria Ruth Carnes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1922894559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 WINGED ELM ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295697366",
            "telephone_number": "641-414-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 LEGION ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264825",
            "telephone_number": "843-516-0455",
            "fax_number": "843-962-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESPASS",
        "first_name": "KRISTEN",
        "middle_name": "VICTORIA RUTH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A20991",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "10355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED REHABILITATION COUNSELOR",
            "identifier": "697962",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "CARNES",
            "middle_name": "VICTORIA RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Conway, SC
• Providers in Conway, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.