Individual provider Active NPI

Lindsay Jimmink, LCPC

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1720459340
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC8123 Issued in MD
Practice address
11 E Lexington St Ste 600
Baltimore, MD 21202-1711
Phone
(667) 260-2933
Fax
(301) 609-7284
NPI assigned
Oct 8, 2015
Last updated
Nov 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC8123 MD Primary

Addresses

Primary practice location

11 E Lexington St Ste 600
Baltimore, MD 21202-1711

Mailing address

2709 Federal LN
Bowie, MD 20715-2310
Phone (301) 609-9887

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
LC8123MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mighty Behavioral Health Services Past Accepting new patients

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, 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": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1720459340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 FEDERAL LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207152310",
            "telephone_number": "301-609-9887",
            "fax_number": "301-609-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E LEXINGTON ST STE 600",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212021711",
            "telephone_number": "667-260-2933",
            "fax_number": "301-609-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMMINK",
        "first_name": "LINDSAY",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC8123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.