Individual provider Active NPI

Kimberly Marie Hughes

  • Mental Health Counselor
  • Milton, FL
National Provider Identifier
1679683577
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH6539 Issued in FL
Practice address
5642 Jones St
Milton, FL 32570-2304
Phone
(850) 626-7779
Fax
(850) 626-7171
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH6539 FL Primary

Addresses

Primary practice location

5642 Jones St
Milton, FL 32570-2304

Mailing address

5642 Jones St
Milton, FL 32570-2304
Phone (850) 626-7779

Other identifiers 1

IdentifierTypeStateIssuer
761614700MedicaidFL

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
MH6539FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Counseling Center LLC Mental Health CurrentSince Dec 1, 2019 Accepting new patients
Serenity Springs Counseling, LLC Mental Health Current Accepting new patients

Locations

5642 Jones St
Milton, FL 32570
Phone (850) 626-7779

4519 Woodbine Rd
Pace, FL 32571
Phone (850) 483-0338

Organizations & group practices 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1679683577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5642 JONES ST",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325702304",
            "telephone_number": "850-626-7779",
            "fax_number": "850-626-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5642 JONES ST",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325702304",
            "telephone_number": "850-626-7779",
            "fax_number": "850-626-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761614700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.