Individual provider Active NPI

William Kimmins, LPC

  • Mental Health Counselor
  • National Harbor, MD
National Provider Identifier
1508560145
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP13889 Issued in MD
Practice address
120 Waterfront St Ste 420
National Harbor, MD 20745-1122
Phone
(410) 635-1294
NPI assigned
Mar 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP13889 MD Primary
Professional Counselor 101YP2500X LPC04287 KS

Addresses

Primary practice location

120 Waterfront St Ste 420
National Harbor, MD 20745-1122

Mailing address

2110 Priest Bridge Dr Ste 1
Crofton, MD 21114-2472
Phone (443) 937-7089

Other practice location 1

2110 Priest Bridge Dr Ste 1
Crofton, MD 21114-2472
Phone (443) 937-7089

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
LGP13889MDMDMental Health Counselor
LPC04287KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
KF Consulting Services LLC Current Accepting new patients
Mirror Mental Health CurrentSince Apr 1, 2023 Accepting new patients

Locations

2110 Priest Bridge Dr
Ste 1
Crofton, MD 21114
Phone (443) 937-7089

120 Waterfront St
Ste 420
Oxon Hill, MD 20745
Phone (240) 647-8262

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1508560145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 PRIEST BRIDGE DR STE 1",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142472",
            "telephone_number": "443-937-7089",
            "fax_number": "443-292-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WATERFRONT ST STE 420",
            "city": "NATIONAL HARBOR",
            "state": "MD",
            "postal_code": "207451122",
            "telephone_number": "410-635-1294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2110 Priest Bridge Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Crofton",
            "state": "MD",
            "postal_code": "211142472",
            "country_code": "US",
            "telephone_number": "443-937-7089",
            "fax_number": "443-292-4570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMMINS",
        "first_name": "WILLIAM",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP13889",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "LPC04287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National Harbor, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.