Individual provider Active NPI

Kimberly Gose, LPCC

  • Professional Counselor
  • Columbia, KY
National Provider Identifier
1407335664
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
299365 Issued in KY
Practice address
1251 Campbellsville Rd
Columbia, KY 42728-2213
Phone
(270) 864-1625
Fax
(270) 384-0610
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 299365 KY Primary

Addresses

Primary practice location

1251 Campbellsville Rd
Columbia, KY 42728-2213

Mailing address

PO Box 91
Columbia, KY 42728-0091
Phone (270) 864-1625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250825000902 KY Practitioner - Mental Health Counselor 3870093883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serenity Counseling Services LLCGroup PAC ID 0143694927, 6 clinicians

Practice addresses (Care Compare)

112 Office Park Dr
Columbia, KY 42728-1380
Phone (270) 864-1625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299365KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Counseling Services LLC CurrentSince Jul 28, 2025 Accepting new patients

Locations

1251 Campbellsville Rd
Columbia, KY 42728
Phone (270) 864-1625

112 Office Park Dr
Columbia, KY 42728
Phone (270) 634-4324

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": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1407335664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427280091",
            "telephone_number": "270-864-1625",
            "fax_number": "270-384-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 CAMPBELLSVILLE RD",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427282213",
            "telephone_number": "270-864-1625",
            "fax_number": "270-384-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSE",
        "first_name": "KIMBERLY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "299365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, KY

Sources for this page

Verify at the official NPI Registry.