Constance Lou Kirk, L.P.C.C.-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E0008453 Issued in OH

Practice address

149 Hamer Rd
Georgetown, OH 45121-9497

Phone

(937) 515-3060

NPI assigned

Nov 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1356596258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 LAKEWOOD LN",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451219037",
            "telephone_number": "937-515-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HAMER RD",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451219497",
            "telephone_number": "937-515-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "CONSTANCE",
        "middle_name": "LOU",
        "credential": "L.P.C.C.-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "071010",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0008453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla M Kemen, CDCA
• Susan M Kiger, LISW-S
• Kandise King
• Amanda Kipp, M.A, ED.S
• Jessica Kirby, PHARMD
• Brianne Elizabeth Kirker, LPN
• Adeline Jane Kirkhart
• Logan Kirkhart
• Patricia Lynn Kirschbaum, CDCA
• Lawrence Keith Kiskaden, R.PH.

• Mental Health Counselor in Georgetown, OH
• Providers in Georgetown, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.