KIMBERLEE A JOHANNESEN – Professional Counselor, NPI 1114667813

KIMBERLEE A JOHANNESEN is a healthcare provider. based in Houston, Texas. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 180.001177 (IL). The NPI Number for KIMBERLEE A JOHANNESEN is 1114667813

Main info

Female
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLEE A JOHANNESEN
NPI
1114667813
Phone
(713) 416-1921
Address
8906 Cardwell Ln
Enumeration Date
30 March 2022
Last Update Date
8 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8662965262
Graduation Year
1990 (36 years ago)
PAC ID
3779935523
Group Practice PAC ID
5597850594
Professional Enrollment ID
I20240216004401
Address ID
IL606025103CH20XXXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,949 MENTAL HEALTH COUNSELOR in TX

Provider Addresses for KIMBERLEE A JOHANNESEN

  • 8906 Cardwell Ln

    Houston, TX 770554732

    Phone: (713) 416-1921

    Type: Location

  • 8906 CARDWELL LN

    HOUSTON, TX 770554732

    Phone: (713) 416-1921

    Type: Mailing

  • 20 N CLARK ST

    CHICAGO, IL 606024109

    Phone: (312) 252-7718

    Type: Location

  • 20 N CLARK ST STE 2750

    CHICAGO, IL 606025103

    Phone: (866) 296-5262

    Fax: (877) 991-8819

    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: 2024-02-16

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
I20240216004401IMental Health CounselorILTBD

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 77055)

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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: 5597850594View full group profile
NameSpecialtyState
Clinical Social WorkerIL
-IL
Mental Health CounselorIL
Clinical Social WorkerIL
-IL
Mental Health CounselorIL
Mental Health CounselorIL
Clinical Social WorkerIL
Clinical Social WorkerIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

Can I cross-check KIMBERLEE A JOHANNESEN using NPI 1114667813?
NPI 1114667813 belongs to KIMBERLEE A JOHANNESEN; compare other details if you need extra assurance.
Would KIMBERLEE A JOHANNESEN appear as active to a payer?
You can treat KIMBERLEE A JOHANNESEN as active for directory purposes; confirm clinical privileges separately.
How would a patient describe KIMBERLEE A JOHANNESEN's focus?
For KIMBERLEE A JOHANNESEN, the primary taxonomy reads as Professional Counselor. Clinical services aligned with this taxonomy classification.
Is KIMBERLEE A JOHANNESEN located near Houston?
KIMBERLEE A JOHANNESEN currently maps to Houston, Texas in this extract.
When was this NPI issued?
Enumeration for KIMBERLEE A JOHANNESEN is noted as March 30, 2022 where the registry provides it.

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