KIM SHIRD – Counselor, NPI 1205873460

Counselor

KIM SHIRD is a healthcare provider. based in Freeport, Illinois. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for KIM SHIRD is 1205873460

Main info

Female

32 Years Of Experience

Accepts Medicare Assignment

Name

KIM SHIRD

NPI

1205873460

Phone

Not provided

Address

PO BOX 813

Enumeration Date

31 May 2006

Last Update Date

8 July 2007

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8153911000

Graduation Year

1994 (32 years ago)

PAC ID

1355784943

Group Practice PAC ID

3779656582

Professional Enrollment ID

I20240212000516

Address ID

IL610322517FR1631XAVEX400

Telehealth

Yes

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience45

Completeness75

Years active:20State licenses:0Digital endpointsOther names

2,308 MENTAL HEALTH COUNSELOR in IL

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Provider Addresses for KIM SHIRD

PO BOX 813
1255 W. EMPIRE
FREEPORT, IL 610320813
Phone:
Type: Mailing
300, Summit Street, Galena Historic District, Galena, Jo Daviess County, Illinois, 61036, United States
GALENA, IL 610361638
Phone: (815) 777-2836
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20240212000516	I	Mental Health Counselor	IL	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61032)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 3779656582View full group profile

Name	Specialty	State
VERONICA NATALIE FLORES (LPC, CADC)	Mental Health Counselor	IL
MOJISOLA ADEDOYIN AYORINDE (PMHNP-BC)	Nurse Practitioner	IL
JOHN STEVEN CUMMINS (M.D.)	P S Y C H I A T R Y	IL
MS. TOYA RHASHINDA HODGES (LCSW, LSW, CADC)	Clinical Social Worker	IL
ROBERT LAIB (LCPC)	Mental Health Counselor	IL
SHAHINA H JAFRY (M.D.)	P S Y C H I A T R Y	IL
MRS. ALEXANDRA KANE (M.S., L.P.C)	Mental Health Counselor	IL
DR. AYESHA K ASHAI (M.D.)	-	IL
UMA SRIVASTAVA (MD)	-	IL
CAROLINE GOLKO (LCSW)	Clinical Social Worker	IL