Active NPI
Kim Elizabeth Winbery, MAHS, LPC, LCPC
- Professional Counselor
- Fayetteville, AR
National Provider Identifier
1508976291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P1309095
- Practice address
- 26 E Meadow St Ste 6
Fayetteville, AR 72701-5357 - Phone
- (479) 431-2159
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 04459 | GA | |
| Professional Counselor | 101YP2500X | 17995 | TX | |
| Professional Counselor | 101YP2500X | CP0007 | NV | |
| Professional Counselor | 101YP2500X | P1309095 | AR | Primary |
Addresses
Primary practice location
26 E Meadow St Ste 6
Fayetteville, AR 72701-5357
Mailing address
26 E Meadow St Ste 6
Fayetteville, AR 72701-5357
Phone (702) 600-1431
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17995 | Other | TX | LPC LICENSE # |
| 212453 | Other | GA | NCC CERTIFICATION # |
| CP0007 | Other | NV | LCPC |
| #P1309095 | Other | AR | LPC |
| 004459 | Other | GA | LPC LICENSE # |
Other names 1
- Kim Elizabeth Terry
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
| License | State | Type | Specialty |
|---|---|---|---|
| P1309095 | AR | MD | Professional Counselor |
| 04459 | GA | MD | Professional Counselor |
| CP0007 | NV | MD | Professional Counselor |
| 17995 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447977600000",
"number": "1508976291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 E MEADOW ST STE 6",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727015357",
"telephone_number": "702-600-1431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 E MEADOW ST STE 6",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727015357",
"telephone_number": "479-431-2159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINBERY",
"first_name": "KIM",
"middle_name": "ELIZABETH",
"credential": "MAHS, LPC, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2015-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "04459",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "17995",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NV",
"license": "CP0007",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1309095",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC LICENSE #",
"identifier": "17995",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCC CERTIFICATION #",
"identifier": "212453",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCPC",
"identifier": "CP0007",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "#P1309095",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC LICENSE #",
"identifier": "004459",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KIM",
"last_name": "TERRY",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.