Active NPI
Diane Mary Kimball, LCSW
- Marriage & Family Therapist
- San Antonio, TX
National Provider Identifier
1295844801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 24284
- Practice address
- 1550 NE Loop 410
Suite 200
San Antonio, TX 78209-1610 - Phone
- (210) 385-0063
- Fax
- (210) 333-0565
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 24284 | TX | |
| Marriage & Family Therapist | 106H00000X | 24284 | TX | Primary |
Addresses
Primary practice location
1550 NE Loop 410
Suite 200
San Antonio, TX 78209-1610
Mailing address
522 Mystic Shores Blvd
Spring Branch, TX 78070-5240
Phone (210) 385-0063
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24284 | Other | TX | TX STATE BD OF EXAM SW |
| 00S99X | Other | TX | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24284 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1295844801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 MYSTIC SHORES BLVD",
"city": "SPRING BRANCH",
"state": "TX",
"postal_code": "780705240",
"telephone_number": "210-385-0063",
"fax_number": "210-333-0565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 NE LOOP 410",
"address_2": "SUITE 200",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782091610",
"telephone_number": "210-385-0063",
"fax_number": "210-333-0565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "DIANE",
"middle_name": "MARY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "24284",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "24284",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX STATE BD OF EXAM SW",
"identifier": "24284",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "00S99X",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.