Individual provider Active NPI

Kimberlee J Carpenter-McKinnerney, M.A., LPC

  • Mental Health Counselor
  • Weatherford, TX
National Provider Identifier
1629752415
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
90673 Issued in TX
Practice address
106 Austin Ave Ste 200
Weatherford, TX 76086-3381
Phone
(817) 565-7743
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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 097.0135752 VT
Mental Health Counselor 101YM0800X 90673 TX Primary

Addresses

Primary practice location

106 Austin Ave Ste 200
Weatherford, TX 76086-3381

Mailing address

1 Main St Ste a
Springfield, VT 05156-2935
Phone (817) 565-7743

Other practice location 1

1 Main St Ste A
Springfield, VT 05156-2935
Phone (817) 565-7743

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
90673TXMDMental Health Counselor
097.0135752VTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1629752415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIN ST STE A",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562935",
            "telephone_number": "817-565-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 AUSTIN AVE STE 200",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760863381",
            "telephone_number": "817-565-7743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Main St Ste A",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VT",
            "postal_code": "051562935",
            "country_code": "US",
            "telephone_number": "817-565-7743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER-MCKINNERNEY",
        "first_name": "KIMBERLEE",
        "middle_name": "J",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "097.0135752",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "90673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.