Active NPI
Kimberly Michele Green, LPC, CSAC
- Professional Counselor
- Hampton, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701007734
- Practice address
- 2202 Executive Dr Ste C
Hampton, VA 23666-6604 - Phone
- (757) 827-7707
- Fax
- (757) 838-2573
- NPI assigned
- Sep 24, 2018
- Last updated
- Sep 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701007734 | VA | Primary |
Addresses
Primary practice location
2202 Executive Dr Ste C
Hampton, VA 23666-6604
Mailing address
2202 Executive Dr Ste C
Hampton, VA 23666-6604
Phone (757) 827-7707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1030 Loftis Blvd
Suite 102
Newport News, VA 23606-2999
Phone (855) 284-7483
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701007734 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
1030 Loftis Blvd
Ste 102
Newport News, VA 23606
Phone (978) 998-5022
5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498
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": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1790269967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2202 EXECUTIVE DR STE C",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236666604",
"telephone_number": "757-827-7707",
"fax_number": "757-838-2573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2202 EXECUTIVE DR STE C",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236666604",
"telephone_number": "757-827-7707",
"fax_number": "757-838-2573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "KIMBERLY",
"middle_name": "MICHELE",
"credential": "LPC, CSAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-24",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701007734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.