Kimberley Marie Stires, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00589300 Issued in NJ

Practice address

101 Hudson St FL 21
Jersey City, NJ 07302-3929

Phone

(201) 252-7121

NPI assigned

May 30, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberley Willyard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1346778743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 COLES ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073021963",
            "telephone_number": "201-252-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HUDSON ST FL 21",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023929",
            "telephone_number": "201-252-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIRES",
        "first_name": "KIMBERLEY",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00589300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "WILLYARD",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stevens Avenue Healthcare Center, LLC
• Trinity Stevens
• Keira Stewart, M.S. CCC-SLP
• Michael S. Stewart, M.D.
• Kamille Stine, LMHC, LPC
• Frances Michelle Stokes, PSY.D.
• Kristyn Stolze, LMT
• Julie Anne Stone
• Shakeema Stone
• Paul M Stoopack, MD

• Mental Health Counselor in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.