Active NPI
Kimberly Hamilton Jackson, M.A. LPC
- Professional Counselor
- Greensboro, NC
National Provider Identifier
1124222955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2182
- Practice address
- 17 Windrock Way
Greensboro, NC 27455-2258 - Phone
- (336) 282-5142
- NPI assigned
- Jun 14, 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2182 | NC | Primary |
Addresses
Primary practice location
17 Windrock Way
Greensboro, NC 27455-2258
Mailing address
17 Windrock Way
Greensboro, NC 27455-2258
Phone (336) 282-5142
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2182 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124222955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 WINDROCK WAY",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274552258",
"telephone_number": "336-282-5142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 WINDROCK WAY",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274552258",
"telephone_number": "336-282-5142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KIMBERLY",
"middle_name": "HAMILTON",
"credential": "M.A. LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "2182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
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.