Jean Ann Kimbrel, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701007665 Issued in VA

Practice address

102 Stonewall Jackson Dr Unit 1
Elizabethton, TN 37643-2987

Phone

(620) 757-6867

NPI assigned

Sep 1, 2018

Last updated

Sep 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1447732870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 STONEWALL JACKSON DR UNIT 1",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432987",
            "telephone_number": "620-757-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 STONEWALL JACKSON DR UNIT 1",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432987",
            "telephone_number": "620-757-6867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Nat Turner Blvd",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "23518",
            "country_code": "US",
            "telephone_number": "620-757-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBREL",
        "first_name": "JEAN",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-01",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.