Individual provider Active NPI

Kimyah M Jean-Charles, LMHC

  • Mental Health Counselor
  • Clifton Park, NY
National Provider Identifier
1902241615
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
855 Route 146 Ste 123
Clifton Park, NY 12065-3890
Phone
(917) 553-6841
NPI assigned
May 8, 2013
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

855 Route 146 Ste 123
Clifton Park, NY 12065-3890

Mailing address

855 Route 146 Ste 123
Clifton Park, NY 12065-3890
Phone (917) 553-6841

Other names 1

  • Kimyah M Saxon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260513003788 NY Practitioner - Mental Health Counselor 5991274466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

855 Route 146
Suite 112
Clifton Park, NY 12065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peace Mental Health Counseling PLLC Mental Health CurrentSince Apr 5, 2026 Accepting new patients

Locations

855 Route 146
Ste 112
Clifton Park, NY 12065

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.

NPI Registry JSON

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1902241615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 ROUTE 146 STE 123",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653890",
            "telephone_number": "917-553-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 ROUTE 146 STE 123",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653890",
            "telephone_number": "917-553-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-CHARLES",
        "first_name": "KIMYAH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMYAH",
            "last_name": "SAXON",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clifton Park, NY

Sources for this page

Verify at the official NPI Registry.