Kimberley Ghezzi

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

92134 Issued in TX

Practice address

5805 Callaghan Rd Ste 206
San Antonio, TX 78228-1127

Phone

(830) 488-7685

NPI assigned

Jan 20, 2025

Last updated

May 30, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 7, 2025 through Jul 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rooted in Wellness Therapy, PLLC

  • Professional Counselor
  • Austin, TX
  • NPI 1255131694
  NPD Authorized official

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1205647047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12790 FM 1560 N",
            "address_2": "#1714",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780238777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 CALLAGHAN RD STE 206",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281127",
            "telephone_number": "830-488-7685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12790 Fm 1560 N Unit 1714",
            "address_purpose": "LOCATION",
            "city": "Helotes",
            "state": "TX",
            "postal_code": "780232270",
            "country_code": "US",
            "telephone_number": "830-488-7685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHEZZI",
        "first_name": "KIMBERLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "92134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aref A Ghayyath, DMD MS
• Saba Sameeh Ghazal, BDS
• Hani S. Ghazi-Birry, OD
• Aida Ghazvini, DDS
• Elena Iulia Gherman, M.D.
• Ghias Jabbour D.D.S ,PLLC
• Shristi Ghimire Adhikari
• Jennifer Ray Ghiselli
• Leon Ghitis, M.D.
• Reza Fredrick Ghohestani, MD PHD

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.