NPIMap

Organization Active NPI

Kimmerly Perry Group Practice

  • Mental Health Counselor
  • Charlestown, MA
National Provider Identifier
1881346450
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KIMMERLY PERRY GROUP PRACTICE
Practice address
24 Common St
Charlestown, MA 02129-3818
Phone
(520) 370-7326
NPI assigned
Jan 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Kimmerly PerryNPI 1871742510
Title
Licsw
Phone
(520) 370-7326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

24 Common St
Charlestown, MA 02129-3818

Mailing address

24 Common St
Charlestown, MA 02129-3818

Other identifiers 1

IdentifierTypeStateIssuer
70010000P23962OtherBLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1881346450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 COMMON ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 COMMON ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293818",
            "telephone_number": "520-370-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMMERLY PERRY GROUP PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "KIMMERLY",
        "authorized_official_title_or_position": "LICSW",
        "authorized_official_telephone_number": "520-370-7326"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "70010000P23962",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.