Kimbra L. O'Brien, LCAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

870001674A Issued in IN

Practice address

1417 N Anthony Blvd
Fort Wayne, IN 46805-5252

Phone

(260) 424-5814

Fax

(260) 424-6423

NPI assigned

Aug 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Caring About People, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Fort Wayne, IN
  • NPI 1477905099
  NPD (past)

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1801378575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 N ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055252",
            "telephone_number": "260-424-5814",
            "fax_number": "260-424-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055252",
            "telephone_number": "260-424-5814",
            "fax_number": "260-424-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KIMBRA",
        "middle_name": "L.",
        "credential": "LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "870001674A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Andrew Nye, D.D.S
• Soe Nyunt, MD
• Afamefuna Joseph Nzekwe
• Kelly E O'Barr, D.P.T.
• Amy E O'Brien, MSW
• Mark D O'Brien, D.O.
• Mary Ann O'Brien, MD
• Kayla-Lyn O'Bryan
• Megan Morris O'Bryan, CRNA
• Rebekah G O'Bryan

• Addiction (Substance Use Disorder) Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.