Kristina Lynn Jerry

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4617-226 Issued in WI

Practice address

4109 67TH St
Kenosha, WI 53142-3836

Phone

(262) 652-9830

NPI assigned

Apr 27, 2020

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not 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.

• Hope and Healing Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lindenhurst, IL
  • NPI 1467160531
  NPD Authorized official
• Oakwood Clinical Associates, LTD

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1447289434

  Professional

  NPD

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1982225322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7880 GENEVA DR",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315152",
            "telephone_number": "949-677-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 67TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423836",
            "telephone_number": "262-652-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERRY",
        "first_name": "KRISTINA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4617-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Jensen
• Laurie Anne Jensen, ATC
• Jeranek Family Chiropractic, LLC
• Janet L Jeranek-Delgreco, D.C.
• Jeremy a Schwartz DPM Wisconsin LTD
• Sara N Jettawi, LPC
• Patricia L. Jindrich, LPC
• Amber Jirschele, NP
• Debra Johansen, PHD
• John C Matteucci Jr MD SC

• Professional Counselor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.