Kimberly Hackman, M.A.,LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12318 Issued in CO

Practice address

2167 N Academy Blvd
Colorado Springs, CO 80909-1507

Phone

(719) 494-5189

Fax

(719) 623-0159

NPI assigned

Feb 27, 2015

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

Enrolled in CO

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 1

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1790141984
  Medicare reassignment Care Compare group NPD
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  Professional

  NPD

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1275925208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2167 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091507",
            "telephone_number": "719-494-5189",
            "fax_number": "719-623-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2167 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091507",
            "telephone_number": "719-494-5189",
            "fax_number": "719-623-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKMAN",
        "first_name": "KIMBERLY",
        "credential": "M.A.,LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "12318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas A. Hackenberg, MD
• Ashley R Hackert, RDN, CDCES
• Allyson Elaine Hackett
• Carolyn K Hackett, NP
• Christian Hackett, RBT
• Joseph Khalil Haddad, LPT
• Nancy Eleanor Haddad, O.T.
• Ann M Haddenhorst, M.D.
• Kelly R Slone Haddock, PT
• Kevin M Haddock, PT

• Professional Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.