Individual provider Active NPI

Kimberly Wildey, LMHC

  • Mental Health Counselor
  • Pleasantville, NY
National Provider Identifier
1215205802
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
002167 Issued in NY
Practice address
75 Cooley St Ste 2
Pleasantville, NY 10570-2933
Phone
(914) 449-4198
NPI assigned
Dec 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 002767 NY
School Counselor 101YS0200X NY
Mental Health Counselor 101YM0800X 002167 NY Primary

Addresses

Primary practice location

75 Cooley St Ste 2
Pleasantville, NY 10570-2933

Mailing address

75 Cooley St Ste 2
Pleasantville, NY 10570-2933
Phone (914) 449-4198

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

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1215205802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 COOLEY ST STE 2",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702933",
            "telephone_number": "914-449-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 COOLEY ST STE 2",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702933",
            "telephone_number": "914-449-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDEY",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "002767",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasantville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.