Individual provider Active NPI

Kimberley Couch, MA

  • Professional Counselor
  • Aiken, SC
National Provider Identifier
1730767468
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10001 Issued in SD
Practice address
205 Barnwell Ave NW
Aiken, SC 29801-3903
Phone
(839) 465-5543
Fax
(803) 500-5065
NPI assigned
Apr 1, 2021
Last updated
Aug 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 10001 SD Primary

Addresses

Primary practice location

205 Barnwell Ave NW
Aiken, SC 29801-3903

Mailing address

6454 Bridgewood Rd
Columbia, SC 29206-2126
Phone (803) 500-5065

Other names 1

  • Kimberley Richardson Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10001SDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Purposeful Wellness Mental Health PastSince Apr 1, 2021 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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1730767468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6454 BRIDGEWOOD RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292062126",
            "telephone_number": "803-500-5065",
            "fax_number": "803-500-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BARNWELL AVE NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013903",
            "telephone_number": "839-465-5543",
            "fax_number": "803-500-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCH",
        "first_name": "KIMBERLEY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "10001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "RICHARDSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.