Kimberly Williams Dillon, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

304945 Issued in MN

Practice address

115 E Lake St Ste 201
Minneapolis, MN 55408-3368

Phone

(612) 200-8440

Fax

(612) 200-8442

NPI assigned

Oct 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1144863960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E LAKE ST STE 201",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083368",
            "telephone_number": "612-200-8440",
            "fax_number": "612-200-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E LAKE ST STE 201",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083368",
            "telephone_number": "612-200-8440",
            "fax_number": "612-200-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "KIMBERLY",
        "middle_name": "WILLIAMS",
        "name_prefix": "Ms.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "304945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "healingpathservices@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "115 E Lake St Ste 201",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554083368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shantinee Yvonne Dillard
• Jessica Dille
• Martha E Dille, M.S. L.P.
• Bridget Dillon, MD
• Charlie Dillon
• Nichelle Dillon, MSW, LICSW
• Tara Colleen Dillon, RN
• Robin Dilts
• Nicholas Mario Dilullo, PA-C
• Harrison Parry Dilworth IV, MD

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.