Active NPI
Kimberly Jean Woodcock, L.M.H.C.
- Mental Health Counselor
- Medway, MA
National Provider Identifier
1942353438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4694
- Practice address
- 165 Main St Unit 213
Medway, MA 02053-1584 - Phone
- (508) 320-5165
- Fax
- (508) 519-0051
- NPI assigned
- Jan 19, 2007
- Last updated
- Jan 15, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4694 | MA | |
| Mental Health Counselor | 101YM0800X | 4694 | MA | Primary |
Addresses
Primary practice location
165 Main St Unit 213
Medway, MA 02053-1584
Mailing address
165 Main St Unit 213
Medway, MA 02053-1584
Phone (508) 320-5165
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M18684 | Other | MA | BCBS MENTAL HEALTH |
| 1306421 | Medicaid | MA | |
| 1308785 | Medicaid | MA | |
| 2220002001 | Other | MA | BCBS SUBSTANCE ABUSE |
Other names 1
- Miss Kimberly J Maniero
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642204800000",
"number": "1942353438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 MAIN ST UNIT 213",
"city": "MEDWAY",
"state": "MA",
"postal_code": "020531584",
"telephone_number": "508-320-5165",
"fax_number": "508-519-0051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 MAIN ST UNIT 213",
"city": "MEDWAY",
"state": "MA",
"postal_code": "020531584",
"telephone_number": "508-320-5165",
"fax_number": "508-519-0051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODCOCK",
"first_name": "KIMBERLY",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "L.M.H.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2022-01-15",
"certification_date": "2022-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "4694",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4694",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MENTAL HEALTH",
"identifier": "M18684",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306421",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1308785",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS SUBSTANCE ABUSE",
"identifier": "2220002001",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "MANIERO",
"middle_name": "J",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Medway, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.