Kimberly Coker

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-20790 Issued in AZ

Practice address

18426 W Dalea Dr
Goodyear, AZ 85338-2625

Phone

(623) 707-7107

NPI assigned

Feb 22, 2023

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Adelante Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wickenburg, AZ
  • NPI 1083772545
  Medicare reassignment NPD
• Adelante Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1215734124
  NPD
• Adelante Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Surprise, AZ
  • NPI 1205994761
  NPD

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1720786262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18426 W DALEA DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382625",
            "telephone_number": "623-707-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18426 W DALEA DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382625",
            "telephone_number": "623-707-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-20790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107111979",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CNS Memory Clinic LLC
• Timothy Lamont Coates II
• Robert Mark Cobo, DO
• Samantha Grace Coco
• Jerome A Cohn, D.P.M.
• Kelvin Coleman, PA-C
• Elynn Colfack
• Brian Collier
• Joy M Collier, DDS
• Cynthia Lynne Collins, M.D.

• Professional Counselor in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.