Individual provider Active NPI

Kimberly Boone, LMHC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1124264171
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002397A Issued in IN
Practice address
5638 Professional Cir
Indianapolis, IN 46241-5042
Phone
(317) 247-8919
NPI assigned
Dec 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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 39002397A IN Primary

Addresses

Primary practice location

5638 Professional Cir
Indianapolis, IN 46241-5042

Mailing address

5638 Professional Cir
Indianapolis, IN 46241-5042
Phone (317) 247-8919

Other identifiers 1

IdentifierTypeStateIssuer
200429240MedicaidIN

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
39002397AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Chatter, LLC Mental Health Current Accepting new patients
Cummins Behavioral Health Systems, Incorporated PastSince Apr 9, 2001 Accepting new patients

Organizations & group practices 2

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": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1124264171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5638 PROFESSIONAL CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462415042",
            "telephone_number": "317-247-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 PROFESSIONAL CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462415042",
            "telephone_number": "317-247-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "KIMBERLY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002397A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200429240",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.