Individual provider Active NPI

Kimberly Thomas, LCPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1104467448
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180016942 Issued in IL
Practice address
2828 N Burling St Apt 201
Chicago, IL 60657-5224
Phone
(417) 766-6963
NPI assigned
Oct 7, 2019
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180016942 IL Primary

Addresses

Primary practice location

2828 N Burling St Apt 201
Chicago, IL 60657-5224

Mailing address

2828 N Burling St Apt 201
Chicago, IL 60657-5224
Phone (417) 766-6963

Other practice location 1

2835 N Sheffield Ave Ste 316
Chicago, IL 60657-5084
Phone (773) 234-2721

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
23135ARMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Science Counseling Current Accepting new patients

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, 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": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1104467448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 N BURLING ST APT 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575224",
            "telephone_number": "417-766-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 N BURLING ST APT 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575224",
            "telephone_number": "417-766-6963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2835 N Sheffield Ave Ste 316",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575084",
            "country_code": "US",
            "telephone_number": "773-234-2721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KIMBERLY",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180016942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; 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.