Laura Kimball, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

85787 Issued in TX

Practice address

4749 Odom Rd
Beaumont, TX 77706-7080

Phone

(409) 200-2220

Fax

(409) 440-3344

NPI assigned

Nov 2, 2021

Last updated

Dec 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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.

• Deer Oaks Geriatric Services P C

  dba Deer Oaks Consultation Services

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  Medicare reassignment NPD
• Newpath Group

  • Professional Counselor
  • Lumberton, TX
  • NPI 1992126254

  Mental Health

  Medicare reassignment NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1821753104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CANYON LAKE CIR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776573701",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4749 ODOM RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067080",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Canyon Lake Cir",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "TX",
            "postal_code": "776573701",
            "country_code": "US",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "LAURA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "85787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "43007593",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tatum J Kieschnick, DC
• Tinsae T Kifle
• Leigh B Kimball, O.D.
• Lacey Gail Kinard, OTR
• King LTC LLC
• Ashley Rene King
• Gloria Jean King, DDS

• Professional Counselor in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.