Kimberley Yvonne Banta, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC010936 Issued in GA

Practice address

300 W Hospital Rd
Ft Eisenhower, GA 30905-5741

Phone

(706) 787-8656

NPI assigned

Sep 22, 2019

Last updated

Dec 20, 2023By the provider in NPPES

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

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Inpatient Psychology Solutions LLC

  • Psychologist
  • Augusta, GA
  • NPI 1497383152

  Mental Health

  Medicare reassignment NPD
• First Focus Faith, LLC

  • Community/Behavioral Health Agency
  • Martinez, GA
  • NPI 1861130932
  NPD (past)
• Georgia Family Crisis Solutions

  • Professional Counselor
  • Martinez, GA
  • NPI 1164637773
  NPD (past)

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

{
    "created_epoch": "1569110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1811548803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3994 MADISON LN",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309099215",
            "telephone_number": "706-836-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FT EISENHOWER",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTA",
        "first_name": "KIMBERLEY",
        "middle_name": "YVONNE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-22",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Apple, D.O.
• Philip A Aubrey, MD
• Caleb Aultman, MD
• Jesica Baker, PA-C
• Ascharya Balaji
• Glenn Ivan Bascon, DO
• Ryan Hartwell Becker, DO
• Michael Donald Beres, M.D.
• Spencer Blankenship, OTD
• David Edward Bonnin, MD

• Mental Health Counselor in Fort Eisenhower, GA
• Providers in Fort Eisenhower, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.