Individual provider Active NPI

Kristin Marie Cousin

  • Professional Counselor
  • Cumberland, MD
National Provider Identifier
1952711368
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC5026 Issued in MD
Practice address
10102 Country Club Rd SE
Cumberland, MD 21502-8339
Phone
(301) 777-2285
Fax
(301) 777-5832
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC5026 MD
Professional Counselor 101YP2500X LC5026 MD Primary

Addresses

Primary practice location

10102 Country Club Rd SE
Cumberland, MD 21502-8339

Mailing address

PO Box 1722
Cumberland, MD 21501-1722
Phone (301) 777-2285

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
LC5026MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1952711368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1722",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215011722",
            "telephone_number": "301-777-2285",
            "fax_number": "301-777-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 COUNTRY CLUB RD SE",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215028339",
            "telephone_number": "301-777-2285",
            "fax_number": "301-777-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSIN",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC5026",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC5026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.