Active NPI
Kimberly Ann Mains, B.A.
- Mental Health Counselor
- Williamsport, PA
National Provider Identifier
1174855126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 435 W 4TH St
Williamsport, PA 17701-6001 - Phone
- (570) 322-7873
- Fax
- (570) 322-8026
- NPI assigned
- Feb 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Clinical Social Worker | 1041C0700X | CW025694 | PA |
Addresses
Primary practice location
435 W 4TH St
Williamsport, PA 17701-6001
Mailing address
435 W 4TH St
Williamsport, PA 17701-6001
Phone (570) 322-7873
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100777700036 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177
Organizations & group practices 1
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": "1265068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748563200000",
"number": "1174855126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "435 W 4TH ST",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177016001",
"telephone_number": "570-322-7873",
"fax_number": "570-322-8026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 W 4TH ST",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177016001",
"telephone_number": "570-322-7873",
"fax_number": "570-322-8026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAINS",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "B.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-02",
"last_updated": "2025-05-30",
"certification_date": "2025-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW025694",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100777700036",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.