Individual provider Active NPI

Kimberly Ann Bennett, LPC

  • Professional Counselor
  • Clarksburg, WV
National Provider Identifier
1083139141
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2407 Issued in WV
Practice address
3 Hospital PLZ
Clarksburg, WV 26301-9316
Phone
(304) 969-3174
Fax
(304) 969-3125
NPI assigned
Aug 10, 2017
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2407 WV
Mental Health Counselor 101YM0800X 2407 WV
Professional Counselor 101YP2500X 2407 WV Primary
School Counselor 101YS0200X 400 WV

Addresses

Primary practice location

3 Hospital PLZ
Clarksburg, WV 26301-9316

Mailing address

3 Hospital PLZ
Clarksburg, WV 26301-9316
Phone (304) 969-3174

Other practice location 1

120 Professional Pl Ste 101
Bridgeport, WV 26330-4599
Phone (304) 513-3495

Other names 1

  • Kimberly Ann Downey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20240105003140 WV Practitioner - Mental Health Counselor 2567819451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2407WVMDProfessional Counselor
400WVMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
GR&W, Inc CurrentSince Jan 1, 2024 Accepting new patients
GR&W, Inc PastSince Nov 18, 2025 Accepting new patients

Locations

120 Professional Pl
Bridgeport, WV 26330
Phone (681) 214-0101

120 Professional Pl
Ste 101
Bridgeport, WV 26330
Phone (304) 369-8878

1005 White Willow Way
Morgantown, WV 26505
Phone (304) 212-7238

1100 Main St
Ste 104
Wheeling, WV 26003
Phone (304) 443-1414

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1083139141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL PLZ",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019316",
            "telephone_number": "304-969-3174",
            "fax_number": "304-969-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL PLZ",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263019316",
            "telephone_number": "304-969-3174",
            "fax_number": "304-969-3125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Professional Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263304599",
            "country_code": "US",
            "telephone_number": "304-513-3495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WV",
            "license": "2407",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2407",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2407",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "WV",
            "license": "400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DOWNEY",
            "middle_name": "ANN",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarksburg, WV

Sources for this page

Verify at the official NPI Registry.