Individual provider Active NPI

Kristan Marie Leonard, LCMHC

  • Mental Health Counselor
  • Pinehurst, NC
National Provider Identifier
1972056422
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14417 Issued in NC
Practice address
289 Olmsted Blvd Ste 1
Pinehurst, NC 28374-8730
Phone
(910) 295-6007
NPI assigned
Aug 2, 2016
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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 14417 NC Primary
Behavior Analyst 103K00000X RBT-15-03491 NC

Addresses

Primary practice location

289 Olmsted Blvd Ste 1
Pinehurst, NC 28374-8730

Mailing address

CMR 489 Box 1384
Apo, AE 09751-0014

Other practice location 1

5816 Creedmoor Rd
Suite 104
Raleigh, NC 27612-2310
Phone (910) 879-6102

Other names 1

  • Kristan Marie Inman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801001277 NC Practitioner - Mental Health Counselor 5193262756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1101 Marco Dr
Suite 200
Apex, NC 27502-2540
Phone (919) 636-5240

400 Westwood Shopping Ctr
Suite 210
Fayetteville, NC 28314-1683
Phone (919) 636-5240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14417NCMDMental Health Counselor
RBT-15-03491NCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, PC CurrentSince May 16, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. CurrentSince May 16, 2024 Accepting new patients

Locations

11000 Optum Cir
Eden Prairie, MN 55344
Phone (888) 445-8745

1101 Marco Dr
Ste 200
Apex, NC 27502
Phone (844) 534-7202

4102 Ben Franklin Blvd
Durham, NC 27704
Phone (919) 972-7700

289 Olmsted Blvd
Ste 1
Pinehurst, NC 28374
Phone (910) 295-6007

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1972056422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "CMR 489 BOX 1384",
            "city": "APO",
            "state": "AE",
            "postal_code": "097510014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 OLMSTED BLVD STE 1",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748730",
            "telephone_number": "910-295-6007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5816 Creedmoor Rd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276122310",
            "country_code": "US",
            "telephone_number": "910-879-6102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "KRISTAN",
        "middle_name": "MARIE",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14417",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "RBT-15-03491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTAN",
            "last_name": "INMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.