Individual provider Active NPI

Kimberly Solis

  • Counseling Psychologist
  • Palm Bay, FL
National Provider Identifier
1043934995
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
1071 Port Malabar Blvd NE
Palm Bay, FL 32905-5161
Phone
(321) 987-7568
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X Primary

Addresses

Primary practice location

1071 Port Malabar Blvd NE
Palm Bay, FL 32905-5161

Mailing address

1071 Port Malabar Blvd NE
Palm Bay, FL 32905-5161
Phone (321) 987-7568

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kimberlys@angelsforkidsoncall.com Health Information Exchange (HIE)
Direct Messaging Address kimberlys@angelsforkidsoncall.com Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1043934995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 PORT MALABAR BLVD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055161",
            "telephone_number": "321-987-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 PORT MALABAR BLVD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055161",
            "telephone_number": "321-987-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberlys@angelsforkidsoncall.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1744 Holbrook Rd NW",
            "city": "Palm Bay",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329078701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberlys@angelsforkidsoncall.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1744 Holbrook Rd NW",
            "city": "Palm Bay",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329078701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.