Active NPI
Kiesa Dawn Desimone, LMHC
- Mental Health Counselor
- St Petersburg, FL
National Provider Identifier
1245875020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 19079
- Practice address
- 1700 66TH St N Ste 301
St Petersburg, FL 33710-5500 - Phone
- (727) 344-9867
- NPI assigned
- Nov 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 19079 | FL | Primary |
Addresses
Primary practice location
1700 66TH St N Ste 301
St Petersburg, FL 33710-5500
Mailing address
1700 66TH St N Ste 301
St Petersburg, FL 33710-5500
Phone (727) 344-9867
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19079 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1245875020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 66TH ST N STE 301",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337105500",
"telephone_number": "727-344-9867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 66TH ST N STE 301",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337105500",
"telephone_number": "727-344-9867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESIMONE",
"first_name": "KIESA",
"middle_name": "DAWN",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-15",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "19079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.