KIMBERLY HUBBARD STURDIVANT M.A., LCMHC, LCAS-A
NPI 1285877902
Counselor - Mental Health in Charlotte, NC

Q: What is Kimberly Sturdivant's NPI number?

The NPI number for Kimberly Sturdivant is 1285877902. It was assigned to this individual provider in the NPPES registry on April 10, 2009.

Q: What is Kimberly Sturdivant's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since April 10, 2009PECOS EnrolledAccepts Medicare Assignment

200 HAWTHORNE LN, CHARLOTTE, NC 28204(704) 384-9414(704) 384-5735 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 2, 2025, Sep 14, 2024, Aug 22, 2023 (3 updates tracked since 2023).

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About Kimberly Hubbard Sturdivant M.a., Lcmhc, Lcas-a NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY HUBBARD STURDIVANT M.A., LCMHC, LCAS-A (NPI 1285877902) is an individual mental health provider in Charlotte, North Carolina, licensed in North Carolina (9082) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1285877902

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKIMBERLY HUBBARD STURDIVANTCredential: M.A., LCMHC, LCAS-A

Location Address200 HAWTHORNE LNCharlotte, NC 28204-2515

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(704) 384-9414

Fax(704) 384-5735

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateApril 10, 2009

Last NPPES UpdateJuly 2, 20253 updates tracked since enumeration

NPPES CertifiedJuly 2, 2025

✔ NPI 1285877902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in NC · 9082

Also ListedCounselorTaxonomy 101Y00000X · License A9082 (NC)

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 3578A (NC)

200 HAWTHORNE LN, Charlotte, NC 28204

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Secondary Practice Locations 2

Location 1284 Executive Park Dr, Suite 100Concord, NC 28025-1831 · Phone (704) 939-1100 ext. 1123 · Fax (704) 939-1173

Location 2920 Blairhill Rd Ste B114Charlotte, NC 28217-1565 · Phone (704) 970-1803

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberly Hubbard Sturdivant M.a., Lcmhc, Lcas-a is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143665711

PECOS Enrollment IDI20240305002967

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WELO SYLVIE OLENGA CRNA

Nurse Anesthetist, Certified Registered