Active NPI
Kimberly A Staten, LPC-ASSOCIATE
- Mental Health Counselor
- Fort Worth, TX
National Provider Identifier
1356254148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 96971
- Practice address
- 3210 Miller Ave
Fort Worth, TX 76119-1948 - Phone
- (817) 531-5605
- NPI assigned
- Sep 23, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 96971 | TX | Primary |
Addresses
Primary practice location
3210 Miller Ave
Fort Worth, TX 76119-1948
Mailing address
PO Box 462
Mansfield, TX 76063-0079
Phone (214) 966-4834
Other practice location 1
201 E Debbie Ln
Mansfield, TX 76063-2924
Phone (817) 914-3251
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790121600000",
"number": "1356254148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 462",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760630079",
"telephone_number": "214-966-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3210 MILLER AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761191948",
"telephone_number": "817-531-5605"
}
],
"practiceLocations": [
{
"address_1": "201 E Debbie Ln",
"address_purpose": "LOCATION",
"city": "Mansfield",
"state": "TX",
"postal_code": "760632924",
"country_code": "US",
"telephone_number": "817-914-3251",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STATEN",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "LPC-ASSOCIATE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-23",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "96971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.