Individual provider Active NPI

Kristen Coleman Kibby, LMSW

  • Clinical Social Worker
  • Pascagoula, MS
National Provider Identifier
1083848048
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
M-8736 Issued in MS
Practice address
4211 Hospital St
Pascagoula, MS 39581-5320
Phone
(228) 283-4140
NPI assigned
May 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X M-8736 MS Primary

Addresses

Primary practice location

4211 Hospital St
Pascagoula, MS 39581-5320

Mailing address

22104 Begonia St
Moss Point, MS 39562-9812
Phone (228) 283-4140

Other identifiers 1

IdentifierTypeStateIssuer
00018214MedicaidMS

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

LicenseStateTypeSpecialty
M-8736MSMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1083848048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22104 BEGONIA ST",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395629812",
            "telephone_number": "228-283-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 HOSPITAL ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815320",
            "telephone_number": "228-283-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBBY",
        "first_name": "KRISTEN",
        "middle_name": "COLEMAN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "M-8736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018214",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.