Individual provider Active NPI

Jennifer Anne Kymla, LMSW

  • Mental Health Counselor
  • Southfield, MI
National Provider Identifier
1346506300
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801089077 Issued in MI
Practice address
22170 West Nine Road
Southfield, MI 48033
Phone
(586) 850-4519
NPI assigned
Apr 4, 2012
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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 6801089077 MI Primary

Addresses

Primary practice location

22170 West Nine Road
Southfield, MI 48033

Mailing address

22170 W 9 Mile Rd
Southfield, MI 48033-6007
Phone (248) 372-6804

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL unknown Health Information Exchange (HIE)
CONNECT URL unknown Health Information Exchange (HIE)
Direct Messaging Address pcerecords.essmichigan@direct.mihin.net Easterseals MORC Health Care, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20191115001036 MI Practitioner - Clinical Social Worker 1153753900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.79 of 100Reported as group
Quality
90.17
Promoting interoperability
83
Improvement activities
40
Cost
86.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1346506300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22170 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480336007",
            "telephone_number": "248-372-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22170 WEST NINE ROAD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "586-850-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYMLA",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801089077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "endpointDescription": "unknown",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22170 west nine road",
            "city": "southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "endpointDescription": "unknown",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "22170 west nine road",
            "city": "southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.essmichigan@direct.mihin.net",
            "affiliation": "Y",
            "affiliationName": "Easterseals MORC Health Care, Inc.",
            "address_1": "2399 E Walton Blvd",
            "city": "Auburn Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483261955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.