Active NPI
Kimberly Anne Charron, RN, LMHP
- Mental Health Counselor
- Grand Island, NE
National Provider Identifier
1861563546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1466
- Practice address
- 2121 N Webb Rd
Suite 200
Grand Island, NE 68803-1751 - Phone
- (308) 384-7119
- NPI assigned
- Nov 13, 2006
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1466 | NE | Primary |
Addresses
Primary practice location
2121 N Webb Rd
Suite 200
Grand Island, NE 68803-1751
Mailing address
PO Box 5855
Grand Island, NE 68802-5855
Phone (308) 384-7119
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025452000 | Medicaid | NE | |
| 4765 | Other | NE | MIDLANDS CHOICE PROVIDER |
| 84717 | Other | NE | BCBS PROVIDER NUMBER |
Other names 1
- Crossroads Counseling Services, P.C.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1466 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Counseling Services PC | Mental Health | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Grand Island, NE
- NPI 1487022083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861563546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5855",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688025855",
"telephone_number": "308-384-7119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 N WEBB RD",
"address_2": "SUITE 200",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688031751",
"telephone_number": "308-384-7119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARRON",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"credential": "RN, LMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "1466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025452000",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE PROVIDER",
"identifier": "4765",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "84717",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CROSSROADS",
"last_name": "SERVICES, P.C.",
"middle_name": "COUNSELING",
"credential": "RN, MS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.