Individual provider Active NPI

Kimberly M Olver, LPC

  • Professional Counselor
  • Country Club Hills, IL
National Provider Identifier
1083851679
Registry record updated Jan 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC000806 Issued in PA
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

Updated by the provider on Jan 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
178-003370ILMDProfessional Counselor
PC000806PAMDProfessional 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.

Verify at the official NPI Registry.