Carol Sue Kimbro, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3839 Issued in OK

Practice address

504 E 24TH St
Tishomingo, OK 73460-3214

Phone

(580) 371-9933

Fax

(580) 371-9944

NPI assigned

Dec 9, 2010

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

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, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chickasaw Nation Division of Health Chickasaw Nation Medical CenterGroup PAC ID 8426957523, 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chickasaw Nation Medical Center Hospital, Ada, OK, CCN 370180

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 and National Provider Directory roles.

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment Care Compare group NPD
• Chickasaw Nation Division of Health

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  Care Compare group NPD
• Project Impact Oklahoma LLC

  • Community/Behavioral Health Agency
  • Madill, OK
  • NPI 1407154933
  NPD Authorized official
• Chickasaw Nation Division of Health

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Ada, OK
  • NPI 1487715587
  Care Compare group
• Chickasaw Nation Division of Health

  • Ambulatory Surgical Clinic/Center
  • Ada, OK
  • NPI 1982863791
  Care Compare group
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Ada, OK
  • NPI 1295399095
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Tishomingo, OK
  • NPI 1649330242

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Ardmore, OK
  • NPI 1730249186

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Purcell, OK
  • NPI 1982764395

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  • Primary Care Clinic/Center
  • Ada, OK
  • NPI 1962563148

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1972806149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603214",
            "telephone_number": "580-371-9933",
            "fax_number": "580-371-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603214",
            "telephone_number": "580-371-9933",
            "fax_number": "580-371-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRO",
        "first_name": "CAROL",
        "middle_name": "SUE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "3839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandra Dawn Justice, MMP
• Danielle Ophellia Kemp, BS, BHRS
• Georgia Kemp
• Cade Joseph Kennison
• Alisha Khan, CF-SLP
• Jesa Leigh King
• Ellen Cierra Kleinert
• Robert D Laing
• Kendra Langford, BHRS BA
• Jessica L Lawley, LPC

• All providers in Tishomingo, OK
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.