Kimberly Rene Carlin, MA, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

621 Michell St
Ridley Park, PA 19078-3718

Phone

(484) 557-8513

NPI assigned

Jun 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1245979582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MICHELL ST",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190783718",
            "telephone_number": "484-557-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MICHELL ST",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190783718",
            "telephone_number": "484-557-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLIN",
        "first_name": "KIMBERLY",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "MA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.kimberlycarlin.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "621 Michell St",
            "city": "Ridley Park",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190783718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellen K Boyda, CRNP
• Melissa T Burkhart, MD
• Andreea Cadar, M.D.
• Latianna Cain-Bush, CRNP
• Cardiovascular Group LLC
• Donna Carnney, RN
• Christine Elizabeth Carroll, AGACNP
• Erin Marie Carty, M.D.
• Cep America LLC
• Certified Lung Associates

• Counselor in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.