KIMBERLY J HARRIS LPCC-S, LICDC
NPI 1790990711
Counselor - Professional in Middletown, OH

Q: What is Kimberly Harris's NPI number?

The NPI number for Kimberly Harris is 1790990711. It was assigned to this individual provider in the NPPES registry on May 12, 2007.

Q: What is Kimberly Harris's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kimberly Harris was last updated on February 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.

Active since May 12, 2007PECOS EnrolledAccepts Medicare Assignment

4464 S DIXIE HWY, MIDDLETOWN, OH 45005(513) 649-8008(513) 649-8004 Get Directions Write a Review

NPPES record last updated: February 9, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 9, 2017, Jan 30, 2017 (2 updates tracked since 2017).

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About Kimberly J Harris Lpcc-s, Licdc NPPES

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

KIMBERLY J HARRIS LPCC-S, LICDC (NPI 1790990711) is an individual professional provider in Middletown, Ohio, licensed in Ohio (E.0003482-SUPV) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1993).

NPPES Registry Identity

NPI1790990711

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKIMBERLY J HARRISCredential: LPCC-S, LICDC

Location Address4464 S DIXIE HWYMiddletown, OH 45005-5464

Mailing Address4464 S Dixie HwyMiddletown, OH 45005-5464 · (513) 649-8008 · Fax (513) 649-8004

Phone(513) 649-8008

Fax(513) 649-8004

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateMay 12, 2007

Last NPPES UpdateFebruary 9, 20172 updates tracked since enumeration

✔ NPI 1790990711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in OH · E.0003482-SUPV

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LICDC.001245 (OH)

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License E.0003482-SUPV (OH)

4464 S DIXIE HWY, Middletown, OH 45005

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Other Identifiers 5

Other0074946OH · Medicaid-odmh

Other0074861OH · Medicaid-odadas

Other236088Nbcc

Other01-0693OH · Carf Certification

OtherH130910OH · Medicare Group Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Molina Healthcare.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 J Harris Lpcc-s, Licdc 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 ID244682458

PECOS Enrollment IDI20240123002790

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.

LISA IGO PCC LCDCIII

Counselor (Professional)