Kimberly Hubbard Sturdivant, M.A., LCMHC, LCAS-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9082 Issued in NC

Practice address

200 Hawthorne LN
Charlotte, NC 28204-2515

Phone

(704) 384-9414

Fax

(704) 384-5735

NPI assigned

Apr 10, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment NPD
• Trupoint Wellness

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1629806443

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Forsyth Memorial Hospital, Inc.

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1194447805
  NPD
• Forsyth Memorial Hospital, Inc.

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Psychiatry Physician
  • Charlotte, NC
  • NPI 1588610471
  NPD
• Trucore Laboratories, LLC

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1730708215
  NPD

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1285877902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-9414",
            "fax_number": "704-384-5735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "284 Executive Park Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280251831",
            "country_code": "US",
            "telephone_number": "704-939-1100 x1123",
            "fax_number": "704-939-1173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Blairhill Rd Ste B114",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282171565",
            "country_code": "US",
            "telephone_number": "704-970-1803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "KIMBERLY",
        "middle_name": "HUBBARD",
        "credential": "M.A., LCMHC, LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A9082",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3578A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "9082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Marie Stump, LCMHCA
• Gage Alexander Stuntz, MD
• Anarthesia Rene Sturdivant, OTR
• Briaunna Sturdivant
• Jordan Sturdivant
• Grace Sturgis, MS, RD, LDN
• Paul Wesley Sturgis Jr., MSW, LCSW
• Amy Elizabeth Sturkey, PT
• Michele Denise Sturkey, RN
• Warren W Sturm, D.D.S.

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.