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CASSANDRA KIMBALL
NPI 1528527124
Counselor - Professional in Baltimore, MD

Active since March 14, 2019PECOS Enrolled
4940 EASTERN AVENUE, COMMUNITY PSYCHIATRY PROGRAM, BALTIMORE, MD 21224(410) 550-2996 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 11, 2025, Mar 14, 2019 (2 updates tracked since 2019).

About Cassandra Kimball NPPES

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

CASSANDRA KIMBALL (NPI 1528527124) is an individual professional provider in Baltimore, Maryland, licensed in Maryland (LC3973) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1528527124
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameCASSANDRA KIMBALL
Location Address4940 EASTERN AVENUE, COMMUNITY PSYCHIATRY PROGRAMBaltimore, MD 21224
Mailing Address4940 Eastern Avenue, Community Psychiatry ProgramBaltimore, MD 21224 · (410) 550-2996
Phone(410) 550-2996
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateMarch 14, 2019
Last NPPES UpdateDecember 11, 20252 updates tracked since enumeration
NPPES CertifiedDecember 11, 2025
✔ NPI 1528527124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MD · LC3973
4940 EASTERN AVENUE, Baltimore, MD 21224
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cassandra Kimball is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820431422
PECOS Enrollment IDI20240212000841
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.

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.

AGNES MWAKINGWE
Student in an Organized Health Care Education/Training Program
4940 EASTERN AVENUE
BALTIMORE, MD 21224
Baltimore City (410) 550-0526
LAURA SAUVE M.D.
Pediatrics
4940 EASTERN AVENUE
BALTIMORE, MD 21224
Baltimore City (410) 550-0967
DR. ODOLPHE AUGUSTIN DO, MPH
Internal Medicine
4940 EASTERN AVENUE, INTERNAL MEDICINE CLINIC
BALTIMORE, MD 21224
Baltimore City (410) 550-3350
AMANDA MICHELLE REISZ LCSW-C
Social Worker (Clinical)
4940 EASTERN AVENUE, COMMUNITY PSYCHIATRY PROGRAM
BALTIMORE, MD 21224
Baltimore City (410) 550-2996
MRS. LAURA TENGELSEN CRIST RD LDN
Dietitian, Registered
4940 EASTERN AVENUE, JOHNS HOPKINS BAYVIEW MEDICAL CENTER CLINICAL NUTRITION
BALTIMORE, MD 21224
Baltimore City (410) 550-1549
DR. RYAN MICHAEL ANTAR MD
Student in an Organized Health Care Education/Training Program
4940 EASTERN AVENUE, 301 BUILDING, ROOM 3112
BALTIMORE, MD 21224
Baltimore City (410) 550-0338
DR. JOHN PAUL LEDET
Student in an Organized Health Care Education/Training Program
4940 EASTERN AVENUE, INTERNAL MEDICINE CLINIC
BALTIMORE, MD 21224
Baltimore City (504) 495-9410
DR. LAHARI RAMAGIRI MD
Student in an Organized Health Care Education/Training Program
4940 EASTERN AVENUE, INTERNAL MEDICINE CLINIC
BALTIMORE, MD 21224
Baltimore City (410) 550-3350

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 Cassandra Kimball's NPI number?

The NPI number for Cassandra Kimball is 1528527124. It was assigned to this individual provider in the NPPES registry on March 14, 2019.

Where is Cassandra Kimball located?

Cassandra Kimball practices at 4940 Eastern Avenue Community Psychiatry Program, Baltimore, MD 21224. The listed phone number is (410) 550-2996.

What is Cassandra Kimball's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Cassandra Kimball enrolled in Medicare?

Yes. Cassandra Kimball is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Cassandra Kimball was last updated on December 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.