Kimberly Vermillion Fogarty, JD, MA, BC-TMH

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

89459 Issued in CA

Practice address

580 Broadway St Ste 208
Laguna Beach, CA 92651-4311

Phone

(949) 424-9755

Fax

(949) 488-0344

NPI assigned

Jan 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Juris Doctor, Master of Arts

State licenses

Practice roles

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.

• Kimberly V. Fogarty, Licensed Marriage & Family Therapy, PC

  • Marriage & Family Therapist
  • Laguna Niguel, CA
  • NPI 1922463660
  NPD (past) Authorized official
• Talkspace LLC

  • Psychologist
  • New York, NY
  • NPI 1306358817
  NPD (past)
• Talkspace Network LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1205329273
  NPD (past)

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

{
    "created_epoch": "1547337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547337600000",
    "number": "1003380049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PACIFICO",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926774242",
            "telephone_number": "949-422-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 BROADWAY ST STE 208",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926514311",
            "telephone_number": "949-424-9755",
            "fax_number": "949-488-0344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 W 60th St Fl 8",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100237953",
            "country_code": "US",
            "telephone_number": "516-847-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "KIMBERLY",
        "middle_name": "VERMILLION",
        "credential": "JD, MA, BC-TMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-13",
        "last_updated": "2019-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "1600014",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "89459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haleh Fazeli, DDS
• Taylor Fazen
• Shayna Rachel Feinerman, RDN
• Michael Jay Fine, M.D.
• Anthony Flowers
• Heather S Forbes
• Laura Forbis-Sauers
• Jon Kirkpatrick Ford, DPM
• Alexis T Francis, ND, LAC
• Davis Tharayil Francis, ND

• Marriage & Family Therapist in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; 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.