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

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: October 18, 2026.

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

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
Open in Google Maps ↗

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, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

3

Medicare enrollment records show Kimberly Sturdivant reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Novant Health Medical Group, LLC
Same address
Neurology
200 HAWTHORNE LN
Charlotte, NC 28204
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,998 clinicians in this Medicare group
NPI 1265949325 (704) 384-9437
Trupoint Wellness
3.6 mi
Community/Behavioral Health
920 BLAIRHILL RD STE B114
Charlotte, NC 28217
  • Reassigned Medicare billing, North Carolina enrollment
  • 3 clinicians in this Medicare group
NPI 1629806443 (704) 970-1803
Forsyth Memorial Hospital Inc
42 mi
Hematology & Oncology
276 OLD MOCKSVILLE RD STE 800
Statesville, NC 28625
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,202 clinicians in this Medicare group
NPI 1649589763 (704) 873-5150

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4239
MRS. ADRIENNE DUNLAP LANE
Nurse Practitioner (Neonatal)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4109
RYAN ALAN WILLIAMSON M.D.
Psychiatry & Neurology (Neurology)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-9437
CHRISSY LATONYA HARRIS AGACNP
Nurse Practitioner (Critical Care Medicine)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4000
JAYME-JO KINNEY
Pharmacist (Pharmacotherapy)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4840
EDEN TEDLA PA-C
Physician Assistant
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-5416
MATTHEW WYNNE SPANGLER MD
Pediatrics
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4021
RAVEN DANIELLE LYLES
Nurse Anesthetist, Certified Registered
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4274

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Kimberly Sturdivant located?

Kimberly Sturdivant practices at 200 Hawthorne Ln, Charlotte, NC 28204. The listed phone number is (704) 384-9414.

What is Kimberly Sturdivant's specialty?

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

Is Kimberly Sturdivant enrolled in Medicare?

Yes. Kimberly Sturdivant is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kimberly Sturdivant's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Sturdivant reassigns Medicare benefits to 3 organizations: Novant Health Medical Group, LLC (Charlotte, NC), Trupoint Wellness (Charlotte, NC) and Forsyth Memorial Hospital Inc (Statesville, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Sturdivant's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Sturdivant accept?

Health plans from Blue Cross and Blue Shield of NC and Cigna Healthcare list Kimberly Sturdivant as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimberly Sturdivant was last updated on July 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.