Kimberly Dawn Durham, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

75106 Issued in TX

Practice address

950 N 4TH St
Longview, TX 75601-5436

Phone

(903) 757-1106

Fax

(903) 757-6076

NPI assigned

Aug 31, 2018

Last updated

Aug 31, 2018By 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

Other identifiers 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

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sabine Valley Regional MHMR CenterGroup PAC ID 0143202580, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sabine Valley Regional MHMR Center

  dba Community Healthcore

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, TX
  • NPI 1639232002

  Professional

  Medicare reassignment Care Compare group NPD
• Sabine Valley Regional MHMR Center

  dba Community Healthcore

  • Family Medicine Physician
  • Longview, TX
  • NPI 1841835022
  NPD

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1952883480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015436",
            "telephone_number": "903-757-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015436",
            "telephone_number": "903-757-1106",
            "fax_number": "903-757-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PROFESSIONAL COUNSELORS",
            "identifier": "75106",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lewis Alvin Duncan, M.D.
• Dawn Dunn
• Travis Mark Dunn, R.PH.
• Christopher L Dunnahoo, MD
• Kristy Dupus, CRNA
• Mark Hutchison Durham, LCSW
• Margaret Jan Duszik, MT
• Charles Darren Duvall, M.D.
• Linda Duvall, M.ED., L.P.C.
• Denver Elaine Dykes, MA, LPC, LCDC-I

• Professional Counselor in Longview, TX
• Providers in Longview, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.