KRYSTAL MARIE GOTTILLA (NPI# 1225686348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225686348 |
| Entity Type | Individual |
| Full Name | KRYSTAL MARIE GOTTILLA |
| Practice Address |
48a Bay State Rd Quincy MA 02171-1512 |
| Practice Telephone | 5165129253 |
| Mailing Telephone | 5165129253 |
| Enumeration Date | 2019-09-02 |
| Last Update Date | 2019-09-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
48A BAY STATE RD |
| City | QUINCY |
| State | MA |
| Zip Code | 02171-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730661190 | Yvonne Ann Roth | Social Worker | 1 Enterprise Drive, Quincy, MA 02171 | 2018-09-03 |
| 1902397631 | Kristen Spain | Registered Nurse | 110 West Squantum St., North Quincy, MA 02171 | 2018-05-29 |
| 1760984777 | Oumaima Mansouri | Counselor | 110 West Squantum Street, Quincy, MA 02171 | 2018-03-06 |
| 1386163699 | Sophonie Belizaire | Assistant Behavior Analyst | South Shore Mental Health, 500 Victory Rd., Quincy, MA 02171 | 2017-09-18 |
| 1306209168 | Katherine R Standish | Family Medicine | 110 W Squantum St Ste 8, North Quincy, MA 02171 | 2016-03-30 |
| 1669852778 | Joseph Odom | Counselor | 43 Old Colony Road, Quincy, MA 02171 | 2015-06-03 |
| 1578825436 | Hoi Yuk Pang | Counselor | 1 Billings Rd, Quincy, MA 02171 | 2012-06-15 |
| 1275862526 | Naeemah Tahira Smith | Counselor | 210a Quincy Shore Dr, Quincy, MA 02171 | 2009-12-16 |
| 1386876779 | Mark Everds | Counselor | 97 Holmes Street, 2nd Floor, North Quincy, MA 02171 | 2009-08-18 |
| 1306014741 | Ping-chiu Chan | Acupuncturist | Chinese Medical Center, 38 Billings Road, Quincy, MA 02171 | 2008-02-20 |
| Find all providers in zip 02171 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389920 | Agnes L Denson | Counselor | 66 Kenon Ln, Quincy, FL 32352-6924 | 2019-11-06 |
| 1174166532 | Jennifer Johnson | Counselor | 4355 High Bridge Rd, Quincy, FL 32351-6128 | 2019-10-17 |
| 1346723202 | Robert Eugene Bates | Counselor | 203 Central Ave So, Quincy, WA 98848 | 2018-09-07 |
| 1033691100 | Hector Ismael Zavala | Counselor | 203 So. Central Ave, Quincy, WA 98848 | 2018-09-05 |
| 1871097220 | Maricella Salazar | Counselor | 203 South Central, Quincy, WA 98848 | 2018-03-21 |
| 1760984777 | Oumaima Mansouri | Counselor | 110 West Squantum Street, Quincy, MA 02171 | 2018-03-06 |
| 1144737636 | James Kenneth Cheatham Jr. | Counselor | 80 Quarry St Apt 3, Quincy, MA 02169-4173 | 2018-01-05 |
| 1831612860 | Matthew Ward | Counselor | 270 County Hospital Rd. #109, Quincy, CA 95971 | 2017-07-21 |
| 1982132577 | Madison Gonzalez | Counselor | 203 So. Central, Quincy, WA 98848 | 2017-05-26 |
| 1922463207 | Brenda Thompson | Counselor | 32 Carpenters Rd, Quincy, FL 32352-0307 | 2015-12-30 |
| Find all providers in QUINCY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.