Church Therapy Associates, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

CHURCH THERAPY ASSOCIATES, LLC

Practice address

3112 W Grand St
Springfield, MO 65802-5201

Phone

(781) 367-2383

NPI assigned

Feb 21, 2023

Organization subpart

No

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

Authorized official

Name

Kristen Kansiewicz, PHD, LPCNPI 1053428722

Title

Director, LPC

Phone

(781) 367-2383

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristen M Kansiewicz

  • Mental Health Counselor
  • Lynn, MA
  • NPI 1053428722
  NPD Authorized official

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1992403711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4223 E STATE HIGHWAY AA",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658035772",
            "telephone_number": "781-367-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 W GRAND ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658025201",
            "telephone_number": "781-367-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH THERAPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "KANSIEWICZ",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "DIRECTOR, LPC",
        "authorized_official_telephone_number": "781-367-2383",
        "authorized_official_credential": "PHD, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053428722",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dalton L Chronister, PLPC
• Debby Chronister, SLP
• Chrysalis Wellness LLC
• Alexis Chum, IBCLC
• Derek Shane Chung, DO
• Charles Church, HIS
• Kay Ann Ciaccio, MS
• Alyssa Susan Cicero, M.S., CCC-SLP
• Lisa Marie Cillessen, PHARMD, RPH
• Sarah A Cimino, D.D.S

• Adult Mental Health Clinic/Center in Springfield, MO
• Providers in Springfield, MO by specialty
• Adult Mental Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.