Kylie Anne Tangen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A15224 Issued in NC

Practice address

3886 Henderson Dr
Jacksonville, NC 28546-5219

Phone

(910) 938-9833

Fax

(910) 938-9835

NPI assigned

May 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pride in North Carolina, LLC

  • Community/Behavioral Health Agency
  • Greenville, NC
  • NPI 1760420186

  Mental Health

  NPD
• Pride in North Carolina, LLC

  • Community/Behavioral Health Agency
  • Jacksonville, NC
  • NPI 1821136581

  Mental Health

  NPD

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1972186047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3886 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465219",
            "telephone_number": "910-938-9833",
            "fax_number": "910-938-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3886 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465219",
            "telephone_number": "910-938-9833",
            "fax_number": "910-938-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGEN",
        "first_name": "KYLIE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Tagg, PSYD, BCBA-D
• Adnan Taj-Eldin, MD
• Takey Crist MD PA (Crist Clinic for Women)
• Stephen Geofrey Tallman, DPT
• Cecilia Maria Tallo, FNP-BC
• Chanele Tangiora
• Bethany K Tant, DDS
• Sabrina Tapia
• Sasidharan Taravath, MD
• Tarheel Emergency Group, PLLC

• Mental Health Counselor in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.