Individual provider Active NPI

Kimberly Stokes, LPC

  • Professional Counselor
  • Forty Fort, PA
National Provider Identifier
1003573163
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC004335 Issued in PA
Practice address
1169 Wyoming Ave
Forty Fort, PA 18704-4003
Phone
(570) 762-9592
NPI assigned
Nov 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC004335 PA Primary

Addresses

Primary practice location

1169 Wyoming Ave
Forty Fort, PA 18704-4003

Mailing address

1169 Wyoming Ave
Forty Fort, PA 18704-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240224000411 PA Practitioner - Mental Health Counselor 9537504006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

1169 Wyoming Ave
Forty Fort, PA 18704-4003
Phone (570) 904-7363

228 S Main Ave
Scranton, PA 18504-2545
Phone (570) 904-7363

254 Daleville Hwy
Covington Township, PA 18444-7951
Phone (570) 904-7363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thaxton Holistic Wellness Center Professional CurrentSince Feb 19, 2024 Accepting new patients

Locations

1169 Wyoming Ave
Forty Fort, PA 18704
Phone (570) 283-3301

2324 Boulevard Ave
Scranton, PA 18509
Phone (570) 343-2244

228 S Main Ave
Scranton, PA 18504
Phone (570) 468-5191

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1003573163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044003",
            "telephone_number": "570-762-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKES",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2022-01-19",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC004335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forty Fort, PA

Sources for this page

Verify at the official NPI Registry.