KIMBERLY J HARRIS (LPCC-S, LICDC) – Professional Counselor, NPI 1790990711

KIMBERLY J HARRIS (LPCC-S, LICDC) is a healthcare provider. based in Middletown, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCC-S, LICDC. They hold a License No. LICDC.001245 (OH). The NPI Number for KIMBERLY J HARRIS (LPCC-S, LICDC) is 1790990711

Main info

Female
33 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY J HARRIS (LPCC-S, LICDC)
NPI
1790990711
Phone
(513) 649-8008
Address
4464 S DIXIE HWY
Enumeration Date
12 May 2007
Last Update Date
9 February 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5136498008
Graduation Year
1993 (33 years ago)
PAC ID
0244682458
Group Practice PAC ID
4880844513
Professional Enrollment ID
I20240123002790
Address ID
OH450055464MI4464XHWYX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:19State licenses:2Digital endpointsOther names

2,616 MENTAL HEALTH COUNSELOR in OH

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Provider Addresses for KIMBERLY J HARRIS (LPCC-S, LICDC)

  • 4464, South Dixie Highway, Middletown, Warren County, Ohio, 45005, United States

    MIDDLETOWN, OH 450055464

    Phone: (513) 649-8008

    Fax: (513) 649-8004

    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: 2024-01-23

PECOS data refreshed: 2026-06-15

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
I20240123002790IMental 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 45005)

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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: 4880844513View full group profile
NameSpecialtyState
Mental Health CounselorOH
Nurse PractitionerOH
Mental Health CounselorOH
P S Y C H I A T R YOH
Mental Health CounselorOH
-OH
Clinical Social WorkerOH
Mental Health CounselorOH
P S Y C H I A T R YOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

What federal number belongs to KIMBERLY J HARRIS (LPCC-S, LICDC)?
The federal identifier for KIMBERLY J HARRIS (LPCC-S, LICDC) is NPI 1790990711.
Is KIMBERLY J HARRIS (LPCC-S, LICDC) active in the national directory?
KIMBERLY J HARRIS (LPCC-S, LICDC)'s public NPI profile is in an active state.
Can you summarize KIMBERLY J HARRIS (LPCC-S, LICDC)'s specialty in plain language?
Clinically, the directory lists KIMBERLY J HARRIS (LPCC-S, LICDC) with Professional Counselor. Clinical services aligned with this taxonomy classification.
What location shows for KIMBERLY J HARRIS (LPCC-S, LICDC)?
We surface Middletown, Ohio for KIMBERLY J HARRIS (LPCC-S, LICDC) based on available NPPES addresses.
How can I contact KIMBERLY J HARRIS (LPCC-S, LICDC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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