Kimberly Lynn Childress, MA, LPC, LCMHCS in Charlotte, NC

Kimberly Lynn Childress, MA, LPC, LCMHCS is a medicare enrolled "Counselor - Mental Health" provider in Charlotte, North Carolina. Her current practice location is 10430 Harris Oak Blvd Ste L, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 360-3637.

Kimberly Lynn Childress is licensed to practice in North Carolina (license number S15220) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043675275.

Contact Information

	Kimberly Lynn Childress, MA, LPC, LCMHCS
	10430 Harris Oak Blvd Ste L, Charlotte, NC 28269-7513
	(704) 360-3637
	(704) 200-9829

Map and Direction

Healthcare Provider's Profile

Full Name	Kimberly Lynn Childress
Gender	Female
Speciality	Counselor - Mental Health
Location	10430 Harris Oak Blvd Ste L, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043675275
Provider Enumeration Date: 12/14/2015
Last Update Date: 12/14/2023

Medicare PECOS Information:

PECOS PAC ID: 0941650139
Enrollment ID: I20231229002939

Medical Identifiers

Medical identifiers for Kimberly Lynn Childress such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043675275	NPI	-	NPPES
EJ7GST1IO450JIH	Medicaid	SC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	6208 (South Carolina)	Secondary
101YM0800X	Counselor - Mental Health	S15220 (North Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Lynn Childress allows following entities to bill medicare on her behalf.

Entity Name	Integrative Wellness Solutions Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447760871 PECOS PAC ID: 8022341494 Enrollment ID: O20190618000993

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Lynn Childress is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kimberly Lynn Childress, MA, LPC, LCMHCS 10430 Harris Oak Blvd Ste L, Charlotte, NC 28269-7513 Ph: (704) 360-3637	Kimberly Lynn Childress, MA, LPC, LCMHCS 10430 Harris Oak Blvd Ste L, Charlotte, NC 28269-7513 Ph: (704) 360-3637

Reviews and Comments

Counselor in Charlotte, NC

Dr. Jeff Randall Mishoe, D.MIN. Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 East Blvd, C-8, Charlotte, NC 28203 Phone: 704-344-1100 Fax: 704-344-1100
Allegra Shonta Cooper, LCMHC Counselor Medicare: Medicare Enrolled Practice Location: 6324 Fairview Rd Ste 460, Charlotte, NC 28210 Phone: 980-302-8611 Fax: 980-302-8624
Meredith Garofalo, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2339 Chesterfield Ave, Charlotte, NC 28205 Phone: 773-263-6765
Reggie Moses, ST. Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 East Blvd, Charlotte, NC 28203 Phone: 704-332-0081 Fax: 704-332-0085
Dr. Terri Lynn Tilford, EDD Counselor Medicare: Not Enrolled in Medicare Practice Location: 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262 Phone: 980-689-4127
Emily Reiner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2511 Yadkin Ave, Charlotte, NC 28205 Phone: 470-289-6301
Lindsey Yvette Donatien, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5200 Park Rd Ste 218b, Charlotte, NC 28209 Phone: 866-700-1606 Fax: 866-338-5921

Kimberly Lynn Childress, MA, LPC, LCMHCS - Medicare Counselor in Charlotte, NC