Katie Kimball, LCPC-C

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

XL6935 Issued in ME

Practice address

25 Middle St
Portland, ME 04101-4869

Phone

(207) 553-3378

NPI assigned

Nov 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1265256754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040748904",
            "telephone_number": "207-553-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MIDDLE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014869",
            "telephone_number": "207-553-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "KATIE",
        "credential": "LCPC-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "XL6935",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL6935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chin Kim, DDS
• Eugene Kim, DDS
• Marina Kim, D.O.
• Paul S. Kim, M.D.
• Yun Ae Kim, D.M.D
• Peter Jeffers Kimball Jr., LCSW
• Katherine Neal Kimmelshue, MD
• Nicole Suzette Kimmes, DDS
• Abby King, PA-C
• Diane Sanford King, CST AS-C

• Professional Counselor in Portland, ME
• Providers in Portland, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.