Individual provider Active NPI

Ricky Cordale Kimes, M.A. LPC

  • Professional Counselor
  • Saint Robert, MO
National Provider Identifier
1437270410
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2023045478 Issued in MO
Practice address
165 Saint Robert Plaza Dr
Saint Robert, MO 65584-3312
Phone
(573) 528-7760
NPI assigned
Apr 3, 2007
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4516 LA
Professional Counselor 101YP2500X LPC006246 GA
Professional Counselor 101YP2500X 2023045478 MO Primary

Addresses

Primary practice location

165 Saint Robert Plaza Dr
Saint Robert, MO 65584-3312

Mailing address

165 Saint Robert Plaza Dr
Saint Robert, MO 65584-3312
Phone (573) 528-7760

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

LicenseStateTypeSpecialty
LPC006246GAMDProfessional Counselor
4516LAMDProfessional Counselor
2023045478MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1437270410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SAINT ROBERT PLAZA DR",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655843312",
            "telephone_number": "573-528-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 SAINT ROBERT PLAZA DR",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655843312",
            "telephone_number": "573-528-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMES",
        "first_name": "RICKY",
        "middle_name": "CORDALE",
        "name_prefix": "Mr.",
        "credential": "M.A.  LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "4516",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006246",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2023045478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Robert, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.