Shatera Kimbrough

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCP11772 Issued in MD

Practice address

1111 Benfield Blvd Ste 200
Millersville, MD 21108-3004

Phone

(443) 414-9976

NPI assigned

Aug 16, 2021

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 MD

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Safe Harbor Behavioral Care LLCGroup PAC ID 0345514675, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Safe Harbor Behavioral Care, LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1316487879

  Mental Health

  Medicare reassignment Care Compare group NPD
• Transit Health LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Linthicum Heights, MD
  • NPI 1700452661
  NPD (past)

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1871268466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BENFIELD BLVD STE 200",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211083004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BENFIELD BLVD STE 200",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211083004",
            "telephone_number": "443-414-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "SHATERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LCP11772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sammy S.W. Kang, MD
• Kristy Keck, L.M.T.
• Shareese Nichole Kess, LCSW-C, CCM
• Stephanie Mary Kestler, LCSW-C
• Mahtab Khoshkhou, DDS
• Knollwood Manor, Inc
• Candice M Kordish, LCPC
• Laura Kort, LGPC
• Corrine Krampf, OTL
• Candice Lane

• Mental Health Counselor in Millersville, MD
• Providers in Millersville, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.