Active NPI
Kimberly Earley
- Mental Health Counselor
- Sarasota, FL
National Provider Identifier
1003655796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MT4871
- Practice address
- 4610 17TH St
Sarasota, FL 34235-1843 - Phone
- (941) 371-8820
- NPI assigned
- May 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MT4871 | FL | Primary |
Addresses
Primary practice location
4610 17TH St
Sarasota, FL 34235-1843
Mailing address
11782 Forest Park Cir
Bradenton, FL 34211-4984
Phone (941) 730-3931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT4871 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Florida Center for Early Childhood, Inc. | Past | Accepting new patients |
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.
-
- Clinic/Center
- Sarasota, FL
- NPI 1831340660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1003655796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11782 FOREST PARK CIR",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342114984",
"telephone_number": "941-730-3931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4610 17TH ST",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342351843",
"telephone_number": "941-371-8820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARLEY",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-22",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MT4871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.