Bonita Croom Kimbrew, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904004147 Issued in VA

Practice address

120 Greenwell Dr
Hampton, VA 23666-1731

Phone

(757) 766-1711

NPI assigned

Jul 17, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bonita.kimbrew@sevhs.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Agape Counseling & Therapeutic Serv, Inc

  • Professional Counselor
  • Hampton, VA
  • NPI 1679830541

  Clinical

  NPD (past)

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1104267228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GREENWELL DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661731",
            "telephone_number": "757-766-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GREENWELL DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661731",
            "telephone_number": "757-766-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBREW",
        "first_name": "BONITA",
        "middle_name": "CROOM",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004147",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "VA",
            "license": "PPS337705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Yung Suk Kim, MD
• Jennifer Kim, PHARMD
• Ji Yon Kim, DDS
• Myung Woong Kim, MD
• Un Chong Kim, NP
• Robin J Kimmeth, N.P.
• Bradley R Kincaid, MD, MS
• Kindred Community Services, LLC
• Jamie Leigh King, M.D.
• Joshua Nathaniel King Sr.

• Clinical Social Worker in Hampton, VA
• Providers in Hampton, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.