Active NPI
Kimberly Qualls, LCPC
- Professional Counselor
- Baltimore, MD
National Provider Identifier
1417248394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC3969
- Practice address
- 1401 Severn St
Suite 201
Baltimore, MD 21230-1740 - Phone
- (410) 752-5525
- Fax
- (410) 752-5531
- NPI assigned
- Apr 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC3969 | MD | Primary |
Addresses
Primary practice location
1401 Severn St
Suite 201
Baltimore, MD 21230-1740
Mailing address
1401 Severn St
Suite 201
Baltimore, MD 21230-1740
Phone (410) 752-5525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC3969 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303776000000",
"number": "1417248394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 SEVERN ST",
"address_2": "SUITE 201",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212301740",
"telephone_number": "410-752-5525",
"fax_number": "410-752-5531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 SEVERN ST",
"address_2": "SUITE 201",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212301740",
"telephone_number": "410-752-5525",
"fax_number": "410-752-5531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUALLS",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-26",
"last_updated": "2011-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC3969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.