Marvin Carl Kidwell

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

KY-1058 Issued in KY

Practice address

274 Southland Dr
Suite # 204
Lexington, KY 40503-1946

Phone

(859) 457-1679

Fax

(859) 278-3451

NPI assigned

Jan 14, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1043496680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 LARKSPUR DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043501",
            "telephone_number": "859-457-1679",
            "fax_number": "859-278-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 SOUTHLAND DR",
            "address_2": "SUITE # 204",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031946",
            "telephone_number": "859-457-1679",
            "fax_number": "859-278-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "MARVIN",
        "middle_name": "CARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "KY-1058",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8993",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "MH8993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kazuhiko Kido
• Kids Strong Pediatric Therapy
• Fatima Zahra Kidwai, M.D
• Alex Kidwell, MS, RD, LD, CLC
• Allison Grace Kidwell
• Allison Saige Kiedinger
• Eleisha H Kiefer, LCSW
• Steven Paul Kiefer, M.D.
• David R. Kielar, M.D.
• Richard Kielar, MD

• Professional Counselor in Lexington, KY
• Providers in Lexington, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.