Kimberly Sulak, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

80519 Issued in TX

Practice address

2117 Avenue I
Rosenberg, TX 77471-2641

Phone

(281) 498-4673

NPI assigned

Jul 26, 2021

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

Opted out of Medicare

Yes, effective Jul 15, 2024 through Jul 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fort Bend Christian Counseling Ctr

  • Professional Counselor
  • Rosenberg, TX
  • NPI 1942742226
  NPD

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1275206302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 TIMOTHY ST",
            "city": "EAST BERNARD",
            "state": "TX",
            "postal_code": "774357416",
            "telephone_number": "281-728-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 AVENUE I",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774712641",
            "telephone_number": "281-498-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULAK",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "80519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Farah Talib, DMD

• Professional Counselor in Rosenberg, TX
• Providers in Rosenberg, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.

Verify at the official NPI Registry.