Individual provider Active NPI

Kathleen Erin Shearman, LIMHP, LPCC

  • Mental Health Counselor
  • Imperial Beach, CA
National Provider Identifier
1770016933
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11072 Issued in NE
Practice address
155 Elm Ave
Imperial Beach, CA 91932-1860
Phone
(402) 658-5809
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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 11072 NE Primary

Addresses

Primary practice location

155 Elm Ave
Imperial Beach, CA 91932-1860

Mailing address

155 Elm Ave
Imperial Beach, CA 91932-1860
Phone (402) 990-9912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20240220004324 CA Practitioner - Mental Health Counselor 3173936507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

138 B Ave
Coronado, CA 92118-1511
Phone (402) 990-9912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11072NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Authentic Healing LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

138 B Ave
San Diego, CA 92118
Phone (619) 437-6209

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1770016933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ELM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321860",
            "telephone_number": "402-990-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ELM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321860",
            "telephone_number": "402-658-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARMAN",
        "first_name": "KATHLEEN",
        "middle_name": "ERIN",
        "credential": "LIMHP, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "11072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial Beach, CA

Sources for this page

Verify at the official NPI Registry.