Individual provider Active NPI

Kimberly C Shields, LCPC

  • Mental Health Counselor
  • Great Falls, MT
National Provider Identifier
1417796012
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
BBH-LCPC-LIC-87655 Issued in MT
Practice address
1900 2ND Ave S
Great Falls, MT 59405-2704
Phone
(406) 454-6973
Fax
(406) 791-9277
NPI assigned
May 22, 2024
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X BBH-LCPC-LIC-87655 MT Primary

Addresses

Primary practice location

1900 2ND Ave S
Great Falls, MT 59405-2704

Mailing address

601 1St Ave N
Great Falls, MT 59401-2510
Phone (406) 454-6973

Other practice location 1

510 1st Ave N
Great Falls, MT 59401-2592
Phone (406) 454-6973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20260202001620 MT Practitioner - Mental Health Counselor 5092293993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

601 1St Ave N
Great Falls, MT 59401-2510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCPC-LIC-87655MTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care Center Incorporated Mental Health CurrentSince Dec 6, 2025 Accepting new patients
County of Cascade PastSince Oct 5, 2025 Accepting new patients

Locations

115 4th St S
Great Falls, MT 59401
Phone (406) 454-6950

1900 2nd Ave S
Great Falls, MT 59405
Phone (406) 268-6269

3420 15th Ave S
Great Falls, MT 59405
Phone (406) 268-7321

601 1st Ave N
Great Falls, MT 59401
Phone (406) 454-5074

Organizations & group practices 2

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1417796012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 1ST AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594012510",
            "telephone_number": "406-454-6973",
            "fax_number": "406-791-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 2ND AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594052704",
            "telephone_number": "406-454-6973",
            "fax_number": "406-791-9277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 1st Ave N",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594012592",
            "country_code": "US",
            "telephone_number": "406-454-6973",
            "fax_number": "406-791-9277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-LCPC-LIC-87655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.