Individual provider Active NPI

Christina L Kirkman, LPCC-S

  • Professional Counselor
  • Middletown, OH
National Provider Identifier
1821325986
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0500217-SUPV Issued in OH
Practice address
4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone
(513) 649-8008
Fax
(513) 649-8004
NPI assigned
Nov 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.0500217-SUPV OH
Professional Counselor 101YP2500X E.0500217-SUPV OH Primary

Addresses

Primary practice location

4464 S Dixie Hwy
Middletown, OH 45005-5464

Mailing address

4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone (513) 649-8008

Other identifiers 4

IdentifierTypeStateIssuer
H130910OtherOHMEDICARE GROUP PTAN
01-0693OtherOHCARF CERTIFICATION
0074861OtherOHMEDICAID-ODADAS
0074946OtherOHMEDICAID-ODMH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240123002984 OH Practitioner - Mental Health Counselor 0648622852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Counseling Services LLCGroup PAC ID 4880844513, 24 clinicians

Practice addresses (Care Compare)

4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone (513) 649-8008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.0500217-SUPVOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Counseling Services LLC Mental Health CurrentSince Jan 8, 2024 Accepting new patients
Access Counseling Services, LLC PastSince Jan 8, 2024 Accepting new patients

Locations

4464 S Dixie Hwy
Middletown, OH 45005
Phone 5136498008 ext. 22

Organizations & group practices 2

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": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1821325986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055464",
            "telephone_number": "513-649-8008",
            "fax_number": "513-649-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055464",
            "telephone_number": "513-649-8008",
            "fax_number": "513-649-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKMAN",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0500217-SUPV",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0500217-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "H130910",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARF CERTIFICATION",
            "identifier": "01-0693",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-ODADAS",
            "identifier": "0074861",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-ODMH",
            "identifier": "0074946",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.