Individual provider Active NPI

Kimberly Ann Mackay-Pearson, LPC

  • Mental Health Counselor
  • Hilton Head, SC
National Provider Identifier
1538734355
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8979 Issued in SC
Practice address
1536 Fording Island Rd Ste 108
Hilton Head, SC 29926-1144
Phone
(940) 594-8698
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8979 SC Primary

Addresses

Primary practice location

1536 Fording Island Rd Ste 108
Hilton Head, SC 29926-1144

Mailing address

1536 Fording Island Rd Ste 108
Hilton Head, SC 29926-1144
Phone (940) 594-8698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20240304002761 SC Practitioner - Mental Health Counselor 4981049632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Group, LLCGroup PAC ID 8123361730, 9 clinicians

Practice addresses (Care Compare)

1555 Fording Island Rd
Suite C1
Hilton Head Island, SC 29926-1176
Phone (843) 815-6789

48 Royal Pointe Dr
Hilton Head, SC 29926-1166
Phone (843) 415-2075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8979SCMDMental Health Counselor
8879SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Group, LLC CurrentSince Jul 7, 2024 Accepting new patients
Kamp Therapy, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

20 Towne Dr
Bluffton, SC 29910
Phone (843) 441-9208

1536 Fording Island Rd
Ste 108
Hilton Head, SC 29926
Phone (940) 594-8698

1555 Fording Island Rd
Ste C1
Hilton Head Island, SC 29926
Phone (843) 815-6789

1536 Fording Island Rd
Hilton Head Island, SC 29926
Phone (843) 683-2655

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": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1538734355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 FORDING ISLAND RD STE 108",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299261144",
            "telephone_number": "940-594-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 FORDING ISLAND RD STE 108",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299261144",
            "telephone_number": "940-594-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAY-PEARSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "8979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head, SC

Sources for this page

Verify at the official NPI Registry.