Kimberly S Carlson, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00011172 Issued in WA

Practice address

34 NE Boistfort St Ste 101
Chehalis, WA 98532-2600

Phone

(360) 740-6264

Fax

(360) 740-6265

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1467586461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320169",
            "telephone_number": "360-740-6264",
            "fax_number": "360-740-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 NE BOISTFORT ST STE 101",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322600",
            "telephone_number": "360-740-6264",
            "fax_number": "360-740-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00011172",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "WA",
            "license": "404607D",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin H. Kim DDS PLLC
• Roland Emmanuell Camps
• Jennifer Lynn Canaan, CDP
• Capital Oncology, PLLC
• Kaitlin Carlson, LMT
• Aaron Carney
• Cynthia Lynn Carter-Sorensen, LMP
• Cascade Sport & Spine Rehabilitation Inc PC
• Kylie Casebolt
• Dara Casey

• Mental Health Counselor in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.