Individual provider Active NPI

Kimberly K Haney, LPC, LCDCIII

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1639544695
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
84799 Issued in TX
Practice address
10851 Scarsdale Blvd Ste 160
Houston, TX 77089-5737
Phone
(281) 824-1480
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 141211 OH
Professional Counselor 101YP2500X C.1700631 OH
Professional Counselor 101YP2500X 84799 TX Primary

Addresses

Primary practice location

10851 Scarsdale Blvd Ste 160
Houston, TX 77089-5737

Mailing address

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

Other practice location 1

1111 W Adoue St
Alvin, TX 77511-2718
Phone (281) 824-1480

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

LicenseStateTypeSpecialty
141211OHMDAddiction (Substance Use Disorder) Counselor
C.1700631OHMDProfessional Counselor
84799TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1639544695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W ADOUE ST",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775112718",
            "telephone_number": "281-824-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10851 SCARSDALE BLVD STE 160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770895737",
            "telephone_number": "281-824-1480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W Adoue St",
            "address_purpose": "LOCATION",
            "city": "Alvin",
            "state": "TX",
            "postal_code": "775112718",
            "country_code": "US",
            "telephone_number": "281-824-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANEY",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LPC, LCDCIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "141211",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1700631",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "84799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.