Individual provider Active NPI

Kimberly Jo Scipione, LPC

  • Professional Counselor
  • Vacaville, CA
National Provider Identifier
1720338221
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6571 Issued in CO
Practice address
7188 Gibson Canyon Rd
Vacaville, CA 95688-9708
Phone
(720) 383-8311
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSB94028908 CA
Professional Counselor 101YP2500X 6571 CO Primary

Addresses

Primary practice location

7188 Gibson Canyon Rd
Vacaville, CA 95688-9708

Mailing address

9695 S Yosemite St
Lone Tree, CO 80124-2888
Phone (720) 383-8311

Other practice location 1

9695 S Yosemite St Ste 372
Lone Tree, CO 80124-2890
Phone (720) 383-8311

Other practice location 2

17728 Sierra Hwy
Santa Clarita, CA 91351-1635
Phone (661) 360-7730

Other identifiers 1

IdentifierTypeStateIssuer
1720338221MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250528003611 CA Practitioner - Clinical Psychologist 1557880903 Reassigns benefits to 2 organizations
I20250729004452 CO Practitioner - Mental Health Counselor 1557880903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7188 Gibson Canyon Rd
Vacaville, CA 95688-9708
Phone (720) 383-8311

7629 S Country Club Pkwy
Aurora, CO 80016-1243
Phone (720) 383-8311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSB94028908CAMDClinical Psychologist
6571COMDClinical Psychologist
11305CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Autism Counseling Center Inc CurrentSince Mar 28, 2025 Accepting new patients

Locations

17728 Sierra Hwy
Santa Clarita, CA 91351
Phone (661) 360-7730

17702 Sierra Hwy
Santa Clarita, CA 91351
Phone (888) 770-5222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19641/brand/1/csg/1/fhir/r4

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1720338221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9695 S YOSEMITE ST",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242888",
            "telephone_number": "720-383-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7188 GIBSON CANYON RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956889708",
            "telephone_number": "720-383-8311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9695 S Yosemite St Ste 372",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801242890",
            "country_code": "US",
            "telephone_number": "720-383-8311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17728 Sierra Hwy",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913511635",
            "country_code": "US",
            "telephone_number": "661-360-7730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCIPIONE",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94028908",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "6571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720338221",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.