Individual provider Active NPI

Kimberly Jo Yenser, LPCC-S

  • Mental Health Counselor
  • Sylvania, OH
National Provider Identifier
1962638155
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.0600643-SUPV Issued in OH
Practice address
5600 Monroe St
Ste. 103B
Sylvania, OH 43560-2731
Phone
(419) 885-5952
NPI assigned
Jun 2, 2009
Last updated
Dec 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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 E.0600643-SUPV OH Primary

Addresses

Primary practice location

5600 Monroe St
Ste. 103B
Sylvania, OH 43560-2731

Mailing address

6912 Wild River Run
Holland, OH 43528-9054
Phone (419) 783-2069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241008001567 OH Practitioner - Mental Health Counselor 1557892098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drescher and Associates Clinical Services LLCGroup PAC ID 0244666170, 9 clinicians

Practice addresses (Care Compare)

615 Kingsbury St
Maumee, OH 43537-1865
Phone (567) 218-0185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vaitkus Psychological Services LLC CurrentSince Aug 23, 2024 Accepting new patients
Drescher and Associates Clinical Services, LLC CurrentSince Aug 23, 2024 Accepting new patients
Center for Solutions in Brief Therapy, Inc. Counselor PastSince Sep 1, 2010 Accepting new patients

Locations

615 Kingsbury St
Maumee, OH 43537
Phone (419) 270-2490

1090 W South Boundary St
Ste 550
Perrysburg, OH 43551
Phone (567) 218-0185

Organizations & group practices 3

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": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1962638155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6912 WILD RIVER RUN",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289054",
            "telephone_number": "419-783-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST",
            "address_2": "STE. 103B",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602731",
            "telephone_number": "419-885-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENSER",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0600643-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.