Individual provider Active NPI

Kristina Crenshaw, LMHC

  • Mental Health Counselor
  • Ponte Vedra Beach, FL
National Provider Identifier
1932288990
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH1853 Issued in FL
Practice address
5000 Sawgrass Village Cir
Suite 9
Ponte Vedra Beach, FL 32082-5045
Phone
(904) 280-8555
Fax
(904) 280-8562
NPI assigned
Nov 2, 2006
Last updated
May 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2016

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 MH1853 FL Primary

Addresses

Primary practice location

5000 Sawgrass Village Cir
Suite 9
Ponte Vedra Beach, FL 32082-5045

Mailing address

185 Summerfield Dr
Ponte Vedra Beach, FL 32082-2636
Phone (904) 273-8119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH1853FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1932288990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SUMMERFIELD DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822636",
            "telephone_number": "904-273-8119",
            "fax_number": "904-273-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SAWGRASS VILLAGE CIR",
            "address_2": "SUITE 9",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320825045",
            "telephone_number": "904-280-8555",
            "fax_number": "904-280-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "KRISTINA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH1853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; 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.