KYMBERLY WHITENBURG – Mental Health Counselor, NPI 1003459751

KYMBERLY WHITENBURG is a healthcare provider. based in Defiance, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. C.1901822-TRNE (OH). The NPI Number for KYMBERLY WHITENBURG is 1003459751

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
KYMBERLY WHITENBURG
NPI
1003459751
Phone
(419) 785-3800
Address
211 BIEDE AVE
Enumeration Date
25 October 2019
Last Update Date
25 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4197853800
Graduation Year
2020 (6 years ago)
PAC ID
5092151316
Group Practice PAC ID
0547293003
Professional Enrollment ID
I20240308003141
Address ID
OH435122408DE211XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

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Provider Addresses for KYMBERLY WHITENBURG

  • 211, Biede Avenue, Defiance, Defiance County, Ohio, 43512, United States

    DEFIANCE, OH 435122497

    Phone: (419) 785-3800

    Mailing address matches the actual address.

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: 2024-03-08

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

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240308003141IMental Health CounselorOHTBD

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 43512)

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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: 0547293003View full group profile
NameSpecialtyState
Mental Health CounselorOH
-OH
Clinical Social WorkerOH
Clinical Social WorkerOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

Does KYMBERLY WHITENBURG have a public NPI I can cite?
Public records show KYMBERLY WHITENBURG under NPI 1003459751.
Is KYMBERLY WHITENBURG's NPI status active today?
Active status means KYMBERLY WHITENBURG's NPI record is not deactivated in the public file.
What services align with KYMBERLY WHITENBURG's listing?
KYMBERLY WHITENBURG's public classification highlights Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is KYMBERLY WHITENBURG tied to Defiance, Ohio?
If you are local to Defiance, Ohio, KYMBERLY WHITENBURG may be relevant to your search.
Why is information missing for KYMBERLY WHITENBURG?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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