Kimberly Dawn Bordner, MA, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

18502 N Wright Rd
Cuba, IL 61427-9551

Phone

(309) 922-3377

NPI assigned

May 14, 2021

Last updated

May 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1124692132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18502 N WRIGHT RD",
            "city": "CUBA",
            "state": "IL",
            "postal_code": "614279551",
            "telephone_number": "309-922-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18502 N WRIGHT RD",
            "city": "CUBA",
            "state": "IL",
            "postal_code": "614279551",
            "telephone_number": "309-922-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDNER",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney K Collins
• Terrah L Cornell, FNP
• County of Fulton (The Clayberg Fulton County Nursing Center)
• Bridgette Dennis, MS CCC-SLP
• Fulton County Comm Dist 3

• Mental Health Counselor in Cuba, IL
• Providers in Cuba, IL by specialty
• Mental Health Counselor in Illinois

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