Active NPI
Kevin Justin Hubbard, LPC
- Professional Counselor
- Philadelphia, PA
National Provider Identifier
1023505146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC010091
- Practice address
- 3900 Ford Rd Ste E
Philadelphia, PA 19131-2001 - Phone
- (267) 908-6363
- NPI assigned
- Apr 13, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC010091 | PA | Primary |
Addresses
Primary practice location
3900 Ford Rd Ste E
Philadelphia, PA 19131-2001
Mailing address
24-4 Valley Rd
Drexel Hill, PA 19026-5414
Phone (484) 682-5615
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 |
|---|---|---|---|
| PC010091 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523577600000",
"number": "1023505146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24-4 VALLEY RD",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190265414",
"telephone_number": "484-682-5615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 FORD RD STE E",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191312001",
"telephone_number": "267-908-6363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "KEVIN",
"middle_name": "JUSTIN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-13",
"last_updated": "2018-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC010091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.