Active NPI
Stephanie Rose Ann Kroutil-McKendry, LCSW
- Mental Health Counselor
- Danvers, MA
National Provider Identifier
1962069500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 224743
- Practice address
- 5 Cherry Hill Dr Ste 120
Danvers, MA 01923-2500 - Phone
- (781) 600-5501
- NPI assigned
- May 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 224743 | MA | Primary |
Addresses
Primary practice location
5 Cherry Hill Dr Ste 120
Danvers, MA 01923-2500
Mailing address
21 Railroad Ave
Swampscott, MA 01907-1821
Phone (781) 600-5501
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
| License | State | Type | Specialty |
|---|---|---|---|
| 224743 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longwood Care, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Swampscott, MA
- NPI 1750827820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1962069500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 RAILROAD AVE",
"city": "SWAMPSCOTT",
"state": "MA",
"postal_code": "019071821",
"telephone_number": "781-600-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 CHERRY HILL DR STE 120",
"city": "DANVERS",
"state": "MA",
"postal_code": "019232500",
"telephone_number": "781-600-5501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROUTIL-MCKENDRY",
"first_name": "STEPHANIE",
"middle_name": "ROSE ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-20",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "224743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.