Kimberly Evette Hearon

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

87000043A Issued in IN

Practice address

5971 Winchester PL
Portage, IN 46368-4915

Phone

(219) 201-0716

NPI assigned

Sep 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pillars of Wellness

  • Psychologist
  • Schererville, IN
  • NPI 1588105225

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1003537515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5971 WINCHESTER PL",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684915",
            "telephone_number": "219-201-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5971 WINCHESTER PL",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684915",
            "telephone_number": "219-201-0716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 E 86th Ave Ste H",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464106236",
            "country_code": "US",
            "telephone_number": "219-323-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEARON",
        "first_name": "KIMBERLY",
        "middle_name": "EVETTE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000043A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen V Headley, D.O.
• Healtheaccess Clinics L.L.C.
• Healtheaccess Clinics L.L.C.
• Healthmasters,Inc.
• Healthy Smiles Portage, LLC
• Rhonda L Heckathorn, LPT
• Ann E Heiligstedt
• Sandra K Helmuth, COTA
• Hendricks County Hospital (Brickyard Healthcare - Portage Care Center)
• Melissa Henry

• Addiction (Substance Use Disorder) Counselor in Portage, IN
• Providers in Portage, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.