Active NPI
Charlotte M. Kimmel, PH.D.
- Forensic Psychologist
- Corsicana, TX
National Provider Identifier
1962918185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 23853
- Practice address
- 2000 W 2ND Ave
Corsicana, TX 75110-2510 - Phone
- (903) 390-2300
- NPI assigned
- Dec 26, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 23853 | TX | Primary |
Addresses
Primary practice location
2000 W 2ND Ave
Corsicana, TX 75110-2510
Mailing address
PO Box 1478
Mexia, TX 76667-1478
Phone (903) 390-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23853 | TX | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514246400000",
"number": "1962918185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1478",
"city": "MEXIA",
"state": "TX",
"postal_code": "766671478",
"telephone_number": "903-390-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 W 2ND AVE",
"city": "CORSICANA",
"state": "TX",
"postal_code": "751102510",
"telephone_number": "903-390-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMEL",
"first_name": "CHARLOTTE",
"middle_name": "M.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-26",
"last_updated": "2017-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Forensic",
"state": "TX",
"license": "23853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corsicana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.