Individual provider Active NPI

Kimberly Michelle Libby, LPC

  • Counselor
  • Austin, TX
National Provider Identifier
1104400399
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
80790 Issued in TX
Practice address
4315 Guadalupe St Ste 206
Austin, TX 78751-3644
Phone
(512) 850-4986
NPI assigned
May 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 80790 TX Primary

Addresses

Primary practice location

4315 Guadalupe St Ste 206
Austin, TX 78751-3644

Mailing address

4315 Guadalupe St Ste 206
Austin, TX 78751-3644
Phone (512) 850-4986

Other practice location 1

7703 N LaMar Blvd Ste 340
Austin, TX 78752-1061
Phone (512) 850-4986

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
80790TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Libby Counseling PLLC Counselor CurrentSince Jan 24, 2021 Accepting new patients

Locations

7703 N Lamar Blvd
Ste 340
Austin, TX 78752
Phone (512) 693-7408

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1104400399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 GUADALUPE ST STE 206",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787513644",
            "telephone_number": "512-850-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 GUADALUPE ST STE 206",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787513644",
            "telephone_number": "512-850-4986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7703 N LaMar Blvd Ste 340",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787521061",
            "country_code": "US",
            "telephone_number": "512-850-4986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "80790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.