Kimberly Dawn Lister, M.ED., QP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2815 Coliseum Centre Dr
Suite 230
Charlotte, NC 28217-1452

Phone

(704) 357-7932

Fax

(704) 357-7921

NPI assigned

May 21, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1255777975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 CHISTOW RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051944",
            "telephone_number": "704-299-9265",
            "fax_number": "704-357-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 COLISEUM CENTRE DR",
            "address_2": "SUITE 230",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171452",
            "telephone_number": "704-357-7932",
            "fax_number": "704-357-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTER",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "credential": "M.ED., QP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Nicole Lisenby, FNP
• Grant Lisetor, DC
• Matthew Lisi
• Aleksandra Liss, PSY.D., LPA
• Linda N List, RPH
• Steven Paul Lister, PA
• Laura Marie Liston, FNP
• Todd M Listwa, M.D.
• Rebecca R Lisy, OT
• Alexander David Litaker, DPT

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.