Active NPI
Kimberly M Olver, LPC
- Professional Counselor
- Country Club Hills, IL
National Provider Identifier
1083851679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC000806
- Practice address
- 4131 191St PL
Country Club Hills, IL 60478-5803 - Phone
- (708) 957-6047
- Fax
- (708) 957-8028
- NPI assigned
- Jan 19, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC000806 | PA | Primary |
| Professional Counselor | 101YP2500X | 178-003370 | IL |
Addresses
Primary practice location
4131 191St PL
Country Club Hills, IL 60478-5803
Mailing address
PO Box 2666
Country Club Hills, IL 60478-8666
Phone (708) 957-6047
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 |
|---|---|---|---|
| 178-003370 | IL | MD | Professional Counselor |
| PC000806 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232323200000",
"number": "1083851679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2666",
"city": "COUNTRY CLUB HILLS",
"state": "IL",
"postal_code": "604788666",
"telephone_number": "708-957-6047",
"fax_number": "708-957-8028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4131 191ST PL",
"city": "COUNTRY CLUB HILLS",
"state": "IL",
"postal_code": "604785803",
"telephone_number": "708-957-6047",
"fax_number": "708-957-8028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLVER",
"first_name": "KIMBERLY",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-19",
"last_updated": "2009-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC000806",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178-003370",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Country Club Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.