KRISTY ANN PENDLETON (LCSW) – Mental Health Counselor, NPI 1659797090

KRISTY ANN PENDLETON (LCSW) is a healthcare provider. based in Idaho falls, Idaho. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LCSW-34365 (ID). The NPI Number for KRISTY ANN PENDLETON (LCSW) is 1659797090

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
KRISTY ANN PENDLETON (LCSW)
NPI
1659797090
Phone
(208) 524-4818
Address
255 B St
Enumeration Date
10 March 2014
Last Update Date
3 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2089745200
Graduation Year
2011 (15 years ago)
PAC ID
6709184518
Group Practice PAC ID
5092167940
Professional Enrollment ID
I20160816000424
Address ID
ID834046159ID1904XDRXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:12State licenses:1Digital endpointsOther names

633 CLINICAL SOCIAL WORKER in ID

Provider Addresses for KRISTY ANN PENDLETON (LCSW)

  • 255 B St

    Idaho Falls, ID 834023566

    Phone: (208) 524-4818

    Fax: (208) 522-6630

    Type: Location

  • 255 B ST

    IDAHO FALLS, ID 834023566

    Phone: (208) 524-4818

    Fax: (208) 522-6630

    Type: Mailing

  • 3656 E VISION DR

    IDAHO FALLS, ID 834015045

    Phone: (208) 313-7449

    Type: Mailing

  • 1301 E 17TH ST

    IDAHO FALLS, ID 834046273

    Phone: (208) 538-3122

    Fax: (208) 881-5295

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-08-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160816000424IClinical Social WorkerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83402)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092167940View full group profile
NameSpecialtyState
Mental Health CounselorID
Mental Health CounselorID
Clinical Social WorkerID
Clinical Social WorkerID
Mental Health CounselorID
Clinical Social WorkerID
Clinical Social WorkerID

Reviews

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Frequently asked questions

How is KRISTY ANN PENDLETON (LCSW) identified in CMS data?
CMS-hosted NPPES data lists KRISTY ANN PENDLETON (LCSW) with NPI 1659797090.
Is KRISTY ANN PENDLETON (LCSW) still practicing?
KRISTY ANN PENDLETON (LCSW) is currently listed as active in the public NPI registry.
What is KRISTY ANN PENDLETON (LCSW) best known for clinically?
Directory data describes KRISTY ANN PENDLETON (LCSW) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where should I expect KRISTY ANN PENDLETON (LCSW) on a map?
Expect Idaho Falls, Idaho as a primary anchor for KRISTY ANN PENDLETON (LCSW) unless the record lists multiple sites.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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