Active NPI
Kimaira Bernardini, LPC
- Professional Counselor
- Middletown, CT
National Provider Identifier
1275163966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4087
- Practice address
- 1250 Silver St
Middletown, CT 06457-3946 - Phone
- (860) 852-1067
- NPI assigned
- Jan 22, 2020
- Last updated
- Jul 1, 2020
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4087 | CT | Primary |
Addresses
Primary practice location
1250 Silver St
Middletown, CT 06457-3946
Mailing address
1250 Silver St
Middletown, CT 06457-3946
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 26, 2024 through Jun 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4087 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1275163966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 SILVER ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 SILVER ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573946",
"telephone_number": "860-852-1067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNARDINI",
"first_name": "KIMAIRA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-22",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "4087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.