Individual provider Active NPI

Kimberly Acheson, LCSW

  • Marriage & Family Therapist
  • Tampa, FL
National Provider Identifier
1972817898
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
SW10560 Issued in FL
Practice address
14614 Chatsworth Manor Cir
Tampa, FL 33626-3304
Phone
(813) 727-0264
NPI assigned
Aug 3, 2010
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X SW10560 FL Primary

Addresses

Primary practice location

14614 Chatsworth Manor Cir
Tampa, FL 33626-3304

Mailing address

14614 Chatsworth Manor Cir
Tampa, FL 33626-3304
Phone (813) 727-0264

Other practice location 1

14614 Chatsworth Manor Cir
Tampa, FL 33626-3304
Phone (813) 727-0264

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW10560FLMDMarriage & Family Therapist

Organizations & group practices 1

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1972817898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14614 CHATSWORTH MANOR CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263304",
            "telephone_number": "813-727-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14614 CHATSWORTH MANOR CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263304",
            "telephone_number": "813-727-0264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14614 Chatsworth Manor Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336263304",
            "country_code": "US",
            "telephone_number": "813-727-0264",
            "fax_number": "813-792-5272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACHESON",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "SW10560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.