Active NPI
Kimberly R Buckley, LMSW
- School Social Worker
- Baltimore, MD
National Provider Identifier
1023898996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 30484
- Practice address
- 3825 Greenspring Ave
Baltimore, MD 21211-1310 - Phone
- (443) 923-7800
- NPI assigned
- Sep 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 30484 | MD | Primary |
| Clinical Social Worker | 1041C0700X | 30484 | MD | |
| Social Worker | 104100000X | 30484 | MD |
Addresses
Primary practice location
3825 Greenspring Ave
Baltimore, MD 21211-1310
Mailing address
3825 Greenspring Ave
Baltimore, MD 21211-1310
Phone (443) 923-7800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30484 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697328000000",
"number": "1023898996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3825 GREENSPRING AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111310",
"telephone_number": "443-923-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3825 GREENSPRING AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212111310",
"telephone_number": "443-923-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "KIMBERLY",
"middle_name": "R",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-29",
"last_updated": "2023-10-15",
"certification_date": "2023-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MD",
"license": "30484",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "30484",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "30484",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.