Kimberly Ann Ivester, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC004483 Issued in GA

Practice address

24 Camp LN
Carrollton, GA 30117-8298

Phone

(770) 363-6075

NPI assigned

Jun 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1396315552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 GEORGIA HIGHWAY 120",
            "city": "TALLAPOOSA",
            "state": "GA",
            "postal_code": "301763215",
            "telephone_number": "770-574-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CAMP LN",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301178298",
            "telephone_number": "770-363-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVESTER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC004483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Insight Psychiatric Services, Inc
• Integrative Body Health, PC
• Interventional Spine and Pain Management Center, PC
• William Curtis Irby, M.D.
• Vonita Isidore, CNA
• Tondra Ivey, NP-C
• Jack W Miller
• Holly M Jackson, NP
• Janet Jackson, LPC
• Melinda W. Jackson, OTR/L

• Mental Health Counselor in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.