Kimberly S. Carter, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

64063 Issued in TX

Practice address

1527 Hemphill St
Fort Worth, TX 76104-4706

Phone

(817) 569-5911

Fax

(817) 569-5998

NPI assigned

Nov 30, 2006

Last updated

Dec 3, 2012By 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 2

Addresses

Other identifiers 3

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

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stellar Clinic CT PLLCGroup PAC ID 0840633368, 46 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stellar Clinic CT PLLC

  • Mental Health Counselor
  • Detroit, MI
  • NPI 1609641042

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1952479941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 PARK GLN",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760363411",
            "telephone_number": "870-941-6002",
            "fax_number": "817-569-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 HEMPHILL ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044706",
            "telephone_number": "817-569-5911",
            "fax_number": "817-569-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KIMBERLY",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A0611079",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "64063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8744LL",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285623901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CHSCN",
            "identifier": "285623902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet S Carter, RN
• Joice A. Carter, R.D.
• Joseph Gene Carter, MD
• Joshua Daniel Carter, MD
• Kia Lashaun Carter, M.D.
• Larry Wayne Carter II, PH.D.
• Latoya Cherrell Carter, M.ED, LPC
• Mary Carmichael Carter
• Mary M Carter, LSA
• Misty Carter, RNFA

• Professional Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.