Organization Active NPI

Authentic Healing LLC

  • Professional Counselor
  • Imperial Beach, CA
National Provider Identifier
1255040812
Registry record updated Sep 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
AUTHENTIC HEALING LLC
Practice address
155 Elm Ave
Imperial Beach, CA 91932-1860
Phone
(402) 990-9912
NPI assigned
Nov 22, 2022
Last updated
Sep 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2026

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

Authorized official

Name
Kathleen Erin Shearman, LPCCNPI 1770016933
Title
Licensed Professional Counselor
Phone
(402) 990-9912

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

155 Elm Ave
Imperial Beach, CA 91932-1860

Mailing address

155 Elm Ave
Imperial Beach, CA 91932-1860
Phone (402) 990-9912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240220004228 CA Part B Supplier - Clinic/Group Practice 3173967973 Receives reassigned benefits from 1 practitioner
Practice locations: Coronado, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789171200000",
    "number": "1255040812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ELM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321860",
            "telephone_number": "402-990-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ELM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321860",
            "telephone_number": "402-990-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A",
        "authorized_official_last_name": "SHEARMAN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "ERIN",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "402-990-9912",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.