Individual provider Active NPI

Kimberly Campbell Tyree, LCPC

  • Counselor
  • Windsor Mill, MD
National Provider Identifier
1770901118
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LC5626 Issued in MD
Practice address
7004 Security Blvd Ste 300-A36
Windsor Mill, MD 21244-2557
Phone
(443) 591-9884
NPI assigned
Apr 2, 2014
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC5626 MD
Counselor 101Y00000X LC5626 MD Primary

Addresses

Primary practice location

7004 Security Blvd Ste 300-A36
Windsor Mill, MD 21244-2557

Mailing address

7004 Security Blvd Ste 300-A36
Windsor Mill, MD 21244-2557
Phone (443) 591-9884

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
LC5626MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Behavioral Health Services, LLC Current Accepting new patients

Locations

7004 Security Blvd
Ste 300
Windsor Mill, MD 21244
Phone (410) 936-3768

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1770901118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7004 SECURITY BLVD STE 300-A36",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442557",
            "telephone_number": "443-591-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7004 SECURITY BLVD STE 300-A36",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442557",
            "telephone_number": "443-591-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL TYREE",
        "first_name": "KIMBERLY",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC5626",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LC5626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.