Individual provider Active NPI

Kimberly Anne Ferguson, LPC

  • Professional Counselor
  • Mt Pleasant, SC
National Provider Identifier
1285460261
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11019 Issued in SC
Practice address
774 S Shelmore Blvd Ste 108
Mt Pleasant, SC 29464-7626
Phone
(843) 936-2566
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11019 SC Primary

Addresses

Primary practice location

774 S Shelmore Blvd Ste 108
Mt Pleasant, SC 29464-7626

Mailing address

2314 Grandiflora Blvd
Charleston, SC 29414-7075
Phone (843) 936-2566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250611000842 SC Practitioner - Mental Health Counselor 8820508559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wildflower Center for CounselingGroup PAC ID 1254710486, 5 clinicians

Practice addresses (Care Compare)

774 S Shelmore Blvd
Suite 108
Mount Pleasant, SC 29464-7626
Phone (843) 936-2566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11019SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wildflower Center for Counseling CurrentSince May 22, 2025 Accepting new patients

Locations

774 S Shelmore Blvd
Ste 108
Mt Pleasant, SC 29464
Phone (843) 936-2566

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.

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1285460261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 GRANDIFLORA BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147075",
            "telephone_number": "843-936-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 S SHELMORE BLVD STE 108",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647626",
            "telephone_number": "843-936-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "11019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.