Individual provider Active NPI

Kimberly Ann Hart, PHD, LCPC, NCC, ACS

  • Professional Counselor
  • Downers Grove, IL
National Provider Identifier
1164902219
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180012371 Issued in IL
Practice address
4932 Main St
Downers Grove, IL 60515-3611
Phone
(773) 517-9657
NPI assigned
Aug 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178009491 IL
School Counselor 101YS0200X 2235576 IL
Professional Counselor 101YP2500X 180012371 IL Primary

Addresses

Primary practice location

4932 Main St
Downers Grove, IL 60515-3611

Mailing address

1121 W Hillcrest Dr Apt 1a
Dekalb, IL 60115-1699
Phone (773) 315-5284

Other practice location 1

290 N. Annie Glidden Drive, GH 416
Niu
DeKalb, IL 60115
Phone (815) 753-9312

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
178009491ILMDMental Health Counselor
180012371ILMDProfessional Counselor
2235576ILMDSchool Counselor

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1164902219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 W HILLCREST DR APT 1A",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601151699",
            "telephone_number": "773-315-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4932 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153611",
            "telephone_number": "773-517-9657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 N. Annie Glidden Drive, GH 416",
            "address_2": "NIU",
            "address_purpose": "LOCATION",
            "city": "DeKalb",
            "state": "IL",
            "postal_code": "60115",
            "country_code": "US",
            "telephone_number": "815-753-9312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD, LCPC, NCC, ACS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178009491",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "IL",
            "license": "2235576",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180012371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.