Kimberly Ann Reardon, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60398032 Issued in WA

Practice address

15 Oregon Ave Ste 111
Tacoma, WA 98409-7461

Phone

(253) 861-5165

NPI assigned

Dec 17, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Ann Bussey Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Creating Success Therapy PLLC

  • Community/Behavioral Health Agency
  • Tacoma, WA
  • NPI 1801551338
  NPD Authorized official

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1154650307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OREGON AVE STE 111",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097461",
            "telephone_number": "253-861-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OREGON AVE STE 111",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097461",
            "telephone_number": "253-861-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-17",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC00046380",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60398032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BUSSEY",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John A Read, MD
• Laurence Brian Ready, MD
• Brian Reagan, M.D.
• Keith Michael Reagan, P.T.
• Ross Maglaque Realica, MD
• Hannah E. Reas, PH.D.
• Alexandrea Rebar, LICSW, MSW, MHP
• Kelly Jean Reber
• Alyssa Nicole Recasner
• Nicholas Reckis, MA

• Mental Health Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.