Individual provider Active NPI

Kimberly Sylvia Klages, PSY.D., LP

  • Psychologist
  • Beaumont, TX
National Provider Identifier
1679133367
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
40747 Issued in TX
Practice address
4749 Odom Rd
Beaumont, TX 77706-7080
Phone
(409) 200-2220
Fax
(409) 440-3344
NPI assigned
Jun 16, 2019
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4159-226 WI
Psychologist 103T00000X 40747 TX Primary

Addresses

Primary practice location

4749 Odom Rd
Beaumont, TX 77706-7080

Mailing address

105 Canyon Lake Cir
Lumberton, TX 77657-3701
Phone (490) 200-2220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023000069 TX Practitioner - Clinical Psychologist 8123516051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

105 Canyon Lake Cir
Lumberton, TX 77657-3701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4159-226WIMDProfessional Counselor
40747TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Newpath Group Professional CurrentSince Aug 14, 2025 Accepting new patients
Nystrom & Associates, LTD PastSince Jan 1, 2024 Accepting new patients
Family Support Services Inc. PastSince Nov 1, 2021 Accepting new patients
Wisconsin School of Professional Psychology Psychologist Past Accepting new patients

Locations

4351 Crow Rd
Beaumont, TX 77706
Phone (409) 299-5555

4749 Odom Rd
Beaumont, TX 77706
Phone (409) 200-2220

105 Canyon Lake Cir
Lumberton, TX 77657
Phone (409) 200-2220

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1679133367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CANYON LAKE CIR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776573701",
            "telephone_number": "490-200-2220",
            "fax_number": "409-440-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4749 ODOM RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067080",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAGES",
        "first_name": "KIMBERLY",
        "middle_name": "SYLVIA",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-16",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4159-226",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "40747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.