Kimberly A Parks, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178012883 Issued in IL

Practice address

7115 Virginia Rd Ste 104
Crystal Lake, IL 60014-3110

Phone

(847) 469-9553

NPI assigned

Oct 1, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1972088466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 VIRGINIA RD STE 104",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143110",
            "telephone_number": "847-732-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 VIRGINIA RD STE 104",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143110",
            "telephone_number": "847-469-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178012883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dhruvi Parikh, DMD
• Mahesh N Parikh, M.D.
• Kelly Ann Parise
• Elisa Park
• Amber Freidalee Parker
• Mackenzie L Parry, RBT-17-31537
• Donalda Pasho
• Taylor Pasquale
• Sayra Pasquesi
• Gita Patel, RPH

• Professional Counselor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.