Individual provider Active NPI

Kimberly Hines, LCSW

  • Clinical Social Worker
  • Moody AFB, GA
National Provider Identifier
1245824440
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18666 Issued in FL
Practice address
3278 Mitchell Blvd
Moody AFB, GA 31699-1500
Phone
(229) 257-2778
NPI assigned
Feb 27, 2021
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW13681 FL
Clinical Social Worker 1041C0700X 18666 FL Primary
Clinical Social Worker 1041C0700X CSW009282 GA

Addresses

Primary practice location

3278 Mitchell Blvd
Moody AFB, GA 31699-1500

Mailing address

3287 Mitchell Blvd
Moody AFB, GA 31699-1500
Phone (229) 257-2778

Other practice location 1

7901 4th St N Ste 300
St Petersburg, FL 33702-4399
Phone (863) 420-5134

Other identifiers 2

IdentifierTypeStateIssuer
114056400MedicaidFL
1366116873OtherFLMINDFULNESS EXPRESSIONS LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18666FLMDClinical Social Worker
ISW13681FLMDClinical Social Worker
CSW009282GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hedera Counseling Center CurrentSince Oct 27, 2024 Accepting new patients

Locations

3280 Mitchell Blvd
Moody AFB, GA 31699
Phone (229) 257-2778

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1245824440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3287 MITCHELL BLVD",
            "city": "MOODY AFB",
            "state": "GA",
            "postal_code": "316991500",
            "telephone_number": "229-257-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3278 MITCHELL BLVD",
            "city": "MOODY AFB",
            "state": "GA",
            "postal_code": "316991500",
            "telephone_number": "229-257-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 4th St N Ste 300",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337024399",
            "country_code": "US",
            "telephone_number": "863-420-5134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINES",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW13681",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "18666",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009282",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114056400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINDFULNESS EXPRESSIONS LLC",
            "identifier": "1366116873",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moody AFB, GA

Sources for this page

Verify at the official NPI Registry.