Kimberly Ann Sutherland, L.C.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180007152 Issued in IL

Practice address

106 W Bartlett Ave
Suite 2C
Bartlett, IL 60103-7880

Phone

(630) 837-5303

Fax

(630) 837-5305

NPI assigned

May 1, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1304208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304208000000",
    "number": "1093006637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W BARTLETT AVE",
            "address_2": "SUITE 2C",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601037880",
            "telephone_number": "630-837-5303",
            "fax_number": "630-837-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W BARTLETT AVE",
            "address_2": "SUITE 2C",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601037880",
            "telephone_number": "630-837-5303",
            "fax_number": "630-837-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "L.C.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-01",
        "last_updated": "2011-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180007152",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180007152",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Bartlett, IL
• Providers in Bartlett, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2011; 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.