Individual provider Active NPI

Kimara Latoya Burnside

  • Mental Health Counselor
  • Mansfield, TX
National Provider Identifier
1184533416
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
305 Regency Pkwy Ste 601
Mansfield, TX 76063-7306
Phone
(817) 217-4730
NPI assigned
Sep 2, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

305 Regency Pkwy Ste 601
Mansfield, TX 76063-7306

Mailing address

4536 Rush River TRL
Fort Worth, TX 76123-2708
Phone (682) 390-7363

Other names 1

  • Kimara Beck Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1184533416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4536 RUSH RIVER TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232708",
            "telephone_number": "682-390-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 REGENCY PKWY STE 601",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637306",
            "telephone_number": "817-217-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNSIDE",
        "first_name": "KIMARA",
        "middle_name": "LATOYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMARA",
            "last_name": "BECK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.