Active NPI
Kimberly Hines, LCSW
- Clinical Social Worker
- Moody AFB, GA
National Provider Identifier
1245824440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18666
- Practice address
- 3278 Mitchell Blvd
Moody AFB, GA 31699-1500 - Phone
- (229) 257-2778
- NPI assigned
- Feb 27, 2021
- Last updated
- Nov 18, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114056400 | Medicaid | FL | |
| 1366116873 | Other | FL | MINDFULNESS 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18666 | FL | MD | Clinical Social Worker |
| ISW13681 | FL | MD | Clinical Social Worker |
| CSW009282 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hedera Counseling Center | Current | 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.
-
dba Kimberly Hines
- Community/Behavioral Health Agency
- Moody AFB, GA
- NPI 1366116873
-
- Mental Health Counselor
- Moody AFB, GA
- NPI 1083296610
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.