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Deactivated NPI 1104493295 Deactivated / Inactive NPI Female Practitioner

Kris Tina Mcdaniel

Counselor • Meridian, ID

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kris Mcdaniel has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 07, 2021
NPI Deactivation Date October 23, 2024
Total Practice Duration ~3 Years of Practice (2021 – 2024)

Professional Overview & Biography Verified Profile Summary

Kris Mcdaniel was a registered Counselor practicing in Meridian, ID. Throughout an active medical career spanning 3 years, Kris Mcdaniel provided care at the practice location at 2863 E LUCCA DR until profile deactivation on 2024-10-23.

Practice Location & Contact Primary Location

Practice Address

2863 E Lucca Dr

Meridian, ID 836423011

Telephone 2084407676

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Meridian, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.0 Yrs
State Avg: 10.6 Yrs
Regional Practice Density
41 Specialists

Practicing in Meridian, ID (507 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License ID LC-4041

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated October 23, 2024

Record deactivated on October 23, 2024

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Updated Practice Location May 25, 2023

Registered at 1859 S TOPAZ WAY #102, MERIDIAN, ID 836423011 (Tel: 2085195041)

NPI Profile Active June 07, 2021

NPI status registered as active in NPPES database

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Updated Practice Location June 07, 2021

Registered at 2863 E LUCCA DR, MERIDIAN, ID 836423011 (Tel: 2084407676)

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Updated Business Mailing Address June 07, 2021

Registered at 2863 E LUCCA DR, MERIDIAN, ID 836423011 (Tel: 2084407676)

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Provider Name / Credentials Updated June 07, 2021

Recorded as KRIS MCDANIEL

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 07, 2021

Counselor (License #LC-4041 in ID)

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Initial NPI Registration & Enumeration June 07, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104493295
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 07, 2021
Last Update: June 07, 2021
Deactivation Date: October 23, 2024

Mailing Address

2863 E Lucca Dr

Meridian, ID 836423011

Phone: 2084407676

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.