Active NPI
Kim Harmon, MSW, LICSW
- Clinical Social Worker
- Shakopee, MN
National Provider Identifier
1093713935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 843
- Practice address
- 200 4TH Ave W
Government Center RM 300
Shakopee, MN 55379-1220 - Phone
- (952) 496-8155
- Fax
- (952) 496-8355
- NPI assigned
- Jul 13, 2005
- Last updated
- Jul 20, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 843 | MN | Primary |
Addresses
Primary practice location
200 4TH Ave W
Government Center RM 300
Shakopee, MN 55379-1220
Mailing address
200 4TH Ave W
Government Center RM 300
Shakopee, MN 55379-1220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 642058300 | Medicaid | MN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 843 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279584000000",
"number": "1093713935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 4TH AVE W",
"address_2": "GOVERNMENT CENTER RM 300",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553791220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 4TH AVE W",
"address_2": "GOVERNMENT CENTER RM 300",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553791220",
"telephone_number": "952-496-8155",
"fax_number": "952-496-8355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARMON",
"first_name": "KIM",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-13",
"last_updated": "2010-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "843",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "642058300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shakopee, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.