Audrey W Kilgore, BS, TCM, MMHC, CCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2140 Kingsley Ave Ste 2
Orange Park, FL 32073-5129

Phone

(904) 579-3515

NPI assigned

Nov 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685750400000",
    "number": "1659081818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TREE STAND CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322343068",
            "telephone_number": "904-626-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE STE 2",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735129",
            "telephone_number": "904-579-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "AUDREY",
        "middle_name": "W",
        "credential": "BS, TCM, MMHC, CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2023-06-03",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, 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 Jun 3, 2023; 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.