Active NPI
Kimberly Benton-Herzberg, M.S.W
- Mental Health Counselor
- Ames, IA
National Provider Identifier
1114991320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 00593
- Practice address
- 118 Hayward Ave Suite 8
Ames, IA 50014 - Phone
- (515) 290-1534
- Fax
- (319) 865-3110
- NPI assigned
- Feb 14, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 00593 | IA | Primary |
Addresses
Primary practice location
118 Hayward Ave Suite 8
Ames, IA 50014
Mailing address
124 Meadow LN
Nevada, IA 50201-2208
Phone (515) 382-2004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0058230 | Medicaid | IA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00593 | IA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center Associates | Past | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114991320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 MEADOW LN",
"city": "NEVADA",
"state": "IA",
"postal_code": "502012208",
"telephone_number": "515-382-2004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 HAYWARD AVE SUITE 8",
"city": "AMES",
"state": "IA",
"postal_code": "50014",
"telephone_number": "515-290-1534",
"fax_number": "319-865-3110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTON-HERZBERG",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "M.S.W",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "00593",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0058230",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ames, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.