Kimberly Beasley, LMHC,LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

20951 Issued in FL

Practice address

410 S Ware Blvd Ste 844
Tampa, FL 33619-4469

Phone

(813) 362-6788

Fax

(813) 830-7348

NPI assigned

May 7, 2021

Last updated

Feb 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 FL

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

E5 TherapyGroup PAC ID 8527478627, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• E5 Therapy Inc.

  • Mental Health Counselor
  • Tampa, FL
  • NPI 1083390124
  Medicare reassignment Care Compare group NPD
• E5 Therapy

  • Mental Health Counselor
  • Suisun City, CA
  • NPI 1609405174
  NPD

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1558945394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SUNSET AVE STE 200",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945852003",
            "telephone_number": "707-225-7899",
            "fax_number": "707-759-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S WARE BLVD STE 844",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194469",
            "telephone_number": "813-362-6788",
            "fax_number": "813-830-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "KIMBERLY",
        "credential": "LMHC,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0704011203",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "20951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Renee Beard
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• Annie Beardsley, LCSW
• Amy Lynne Bearison
• Janie Davenport Beasley, RPH
• Sterling C. Beasley, D.M.D.
• Ernis Y Beato
• Marilyn Beato
• Angel David Beaton Villafruela, SA-C
• Beatriz Totzke DDS PA (All Ages Dental Spa)

• Mental Health Counselor in Tampa, FL
• Providers in Tampa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.