Individual provider Active NPI

Kimberly Legg, LMHC

  • Mental Health Counselor
  • Lakeland, FL
National Provider Identifier
1780092049
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH14455 Issued in FL
Practice address
708 Jefferson Ave
Lakeland, FL 33801-5637
Phone
(863) 640-1291
NPI assigned
Jul 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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 MH14455 FL Primary

Addresses

Primary practice location

708 Jefferson Ave
Lakeland, FL 33801-5637

Mailing address

708 Jefferson Ave
Lakeland, FL 33801-5637
Phone (863) 640-1291

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
MH14455FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Smekka, LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1780092049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 JEFFERSON AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015637",
            "telephone_number": "863-640-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 JEFFERSON AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015637",
            "telephone_number": "863-640-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGG",
        "first_name": "KIMBERLY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.