Individual provider Active NPI

Kimberly Shanelle Hatchett, LPC

  • Mental Health Counselor
  • Virginia Beach, VA
National Provider Identifier
1285129072
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701007731 Issued in VA
Practice address
1020 First Colonial Rd Ste a
Virginia Beach, VA 23454-3078
Phone
(757) 395-5342
Fax
(757) 222-5095
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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 0701007731 VA Primary

Addresses

Primary practice location

1020 First Colonial Rd Ste a
Virginia Beach, VA 23454-3078

Mailing address

1020 First Colonial Rd Ste a
Virginia Beach, VA 23454-3078
Phone (757) 395-5342

Other practice location 1

435 Main St
South Boston, VA 24592-3241
Phone (434) 575-0145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20240227002638 VA Practitioner - Mental Health Counselor 3072958230 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701007731VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Behavioral Health Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

523 Madison St
Boydton, VA 23917
Phone (434) 738-0154

424 Hamilton Blvd
South Boston, VA 24592
Phone (434) 572-2936

Organizations & group practices 1

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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southside Behavioral Health 14 clinicians

Practice addresses (Care Compare)

424 Hamilton Blvd
South Boston, VA 24592-5200
Phone (434) 572-2936

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1285129072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 FIRST COLONIAL RD STE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543078",
            "telephone_number": "757-395-5342",
            "fax_number": "757-222-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 FIRST COLONIAL RD STE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543078",
            "telephone_number": "757-395-5342",
            "fax_number": "757-222-5095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Main St",
            "address_purpose": "LOCATION",
            "city": "South Boston",
            "state": "VA",
            "postal_code": "245923241",
            "country_code": "US",
            "telephone_number": "434-575-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATCHETT",
        "first_name": "KIMBERLY",
        "middle_name": "SHANELLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.