Active NPI
Kala Gillim, LCMHC
- Mental Health Counselor
- South Burlington, VT
National Provider Identifier
1639817844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 068.0134587
- Practice address
- 595 Dorset St Ste 5
South Burlington, VT 05403-6240 - Phone
- (802) 373-7030
- NPI assigned
- May 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068.0134587 | VT | Primary |
Addresses
Primary practice location
595 Dorset St Ste 5
South Burlington, VT 05403-6240
Mailing address
PO Box 123
Cambridge, VT 05444-0123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068.0134587 | VT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandrock Counseling LLC | Mental Health | Current | Accepting new patients |
Locations
595 Dorset St
Ste 5
South Burlington, VT 05403
Phone (802) 230-1795
Organizations & group practices 1
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": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1639817844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 123",
"city": "CAMBRIDGE",
"state": "VT",
"postal_code": "054440123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 DORSET ST STE 5",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054036240",
"telephone_number": "802-373-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIM",
"first_name": "KALA",
"credential": "LCMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-26",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068.0134587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.