Individual provider Active NPI

Kevin L Wimbish, LMFT

  • Marriage & Family Therapist
  • Fletcher, NC
National Provider Identifier
1417122318
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1198 Issued in NC
Practice address
43 Foxden Drive Unit 201
Fletcher, NC 28732-5640
Phone
(828) 329-5487
Fax
(828) 676-6259
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1198 NC Primary

Addresses

Primary practice location

43 Foxden Drive Unit 201
Fletcher, NC 28732-5640

Mailing address

PO Box 302
Fletcher, NC 28732-0302
Phone (828) 329-5487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 17, 2024 through Jan 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1198NCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Wellness Centers PLLC Current Accepting new patients
Italk Inc. Marriage & Family Therapist Past Accepting new patients
Summit Wellness Centers, PLLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1417122318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 302",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287320302",
            "telephone_number": "828-329-5487",
            "fax_number": "828-676-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 FOXDEN DRIVE UNIT 201",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287325640",
            "telephone_number": "828-329-5487",
            "fax_number": "828-676-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBISH",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fletcher, NC

Sources for this page

Verify at the official NPI Registry.