Kimberly Dianne Hernandez, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

38374 Issued in TX

Practice address

6750 Hillcrest Plaza Dr Ste 206
Dallas, TX 75230-1438

Phone

(214) 865-9449

Fax

(972) 474-9043

NPI assigned

Jan 21, 2020

Last updated

Jan 21, 2020By the provider in NPPES

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

Electronic endpoints 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

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Faithful Therapy TX CorporationGroup PAC ID 0446778328, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Faithful Therapy TX Corporation

  • Counseling Psychologist
  • Fate, TX
  • NPI 1811706716
  Medicare reassignment Care Compare group
• Preston Hollow Health & Wellness, PLLC

  • Psychologist
  • Dallas, TX
  • NPI 1487183406

  Counseling

  NPD (past)

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1922638758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5924 ROYAL LN STE 258",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752308801",
            "telephone_number": "214-865-9449",
            "fax_number": "972-474-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 HILLCREST PLAZA DR STE 206",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301438",
            "telephone_number": "214-865-9449",
            "fax_number": "972-474-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "KIMBERLY",
        "middle_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "38374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://phhwtherapy.clientsecure.me",
            "affiliation": "N",
            "endpointDescription": "Portal link",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6750 Hillcrest Plaza Dr Ste 206",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752301438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Juanita Hernandez
• Kate Hernandez
• Katelyn Michelle Hernandez, DO
• Kaylin E Hernandez
• Kelly Lee Hernandez, D.C.
• Kristina Jeanne Hernandez, D.O.
• Luis Hernandez, LPC
• Luis Enrique Hernandez
• Maricela Hernandez, ANP
• Mark Andrew Hernandez, L.AC.

• Counseling Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.