Individual provider Active NPI

Kaymo Timmons

  • Mental Health Counselor
  • St Johnsbury, VT
National Provider Identifier
1275863094
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
183 Rocky RDG
St Johnsbury, VT 05819-8850
Phone
(802) 227-7255
NPI assigned
Dec 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

183 Rocky RDG
St Johnsbury, VT 05819-8850

Mailing address

183 Rocky RDG
St Johnsbury, VT 05819-8850
Phone (802) 227-7255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, VT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240226003086 MA Practitioner - Mental Health Counselor 4587009956 Reassigns benefits to 1 organization
I20250416000758 VT Practitioner - Mental Health Counselor 4587009956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Systems, Inc CurrentSince Jan 1, 2024 Accepting new patients
Waxing Crescent Counseling, LLC Mental Health CurrentSince Mar 10, 2025 Accepting new patients
Spectrum Health Systems Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

390 Merrill Rd
Pittsfield, MA 01201
Phone (413) 442-0402

149 Oak St
Westborough, MA 01581

585 Lincoln St
Worcester, MA 01605
Phone (508) 831-0045

10 Mechanic St
Ste 302
Worcester, MA 01608
Phone (508) 792-5400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1275863094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 ROCKY RDG",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058198850",
            "telephone_number": "802-227-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 ROCKY RDG",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058198850",
            "telephone_number": "802-227-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "KAYMO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-29",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.