Kathy Tomblin Kershaw, MA LPC NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4072 Issued in NC

Practice address

100 Europa Dr
Suite 490
Chapel Hill, NC 27517-2357

Phone

(919) 913-4134

Fax

(919) 913-4004

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1598985129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SMITH LEVEL RD APT A22",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275102599",
            "telephone_number": "919-619-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EUROPA DR",
            "address_2": "SUITE 490",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275172357",
            "telephone_number": "919-913-4134",
            "fax_number": "919-913-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHAW",
        "first_name": "KATHY",
        "middle_name": "TOMBLIN",
        "name_prefix": "Mrs.",
        "credential": "MA LPC NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103086",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.