Active NPI
Marie Joanne Kaswandik, MA, LPC
- Professional Counselor
- Winston Salem, NC
National Provider Identifier
1972623171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9716
- Practice address
- 175 Kimel Park Dr
Suite 100
Winston Salem, NC 27103-6951 - Phone
- (336) 718-3550
- Fax
- (336) 277-6981
- NPI assigned
- Mar 30, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C1751 | OR | |
| Professional Counselor | 101YP2500X | 9716 | NC | Primary |
Addresses
Primary practice location
175 Kimel Park Dr
Suite 100
Winston Salem, NC 27103-6951
Mailing address
175 Kimel Park Dr
Suite 100
Winston Salem, NC 27103-6951
Phone (336) 718-3550
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1751 | OR | MD | Professional Counselor |
| 9716 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1972623171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 KIMEL PARK DR",
"address_2": "SUITE 100",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036951",
"telephone_number": "336-718-3550",
"fax_number": "336-277-6981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 KIMEL PARK DR",
"address_2": "SUITE 100",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036951",
"telephone_number": "336-718-3550",
"fax_number": "336-277-6981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASWANDIK",
"first_name": "MARIE",
"middle_name": "JOANNE",
"name_prefix": "Ms.",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C1751",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "9716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.