Kimberly Brodie-Harlan, PH.D, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

0904001687 Issued in VA

Practice address

1008 Old Virginia Beach Rd
Suite 100
Virginia Beach, VA 23451-5564

Phone

(757) 422-2118

Fax

(757) 422-2388

NPI assigned

Aug 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kimberly Brodie and Assoc., IncGroup PAC ID 1951372853, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Kimberly Brodie & Assoc., Inc

  dba Awakenings Counseling Center

  • Counselor
  • Virginia Beach, VA
  • NPI 1144334772
  Medicare reassignment Care Compare group NPD Authorized official
• Innervisions Counseling Inc.

  dba Innervisions

  • Clinical Social Worker
  • Chesapeake, VA
  • NPI 1992888374
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104930759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 OLD VIRGINIA BEACH RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515564",
            "telephone_number": "757-422-2118",
            "fax_number": "757-422-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 OLD VIRGINIA BEACH RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515564",
            "telephone_number": "757-422-2118",
            "fax_number": "757-422-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODIE-HARLAN",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "PH.D, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0904001687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Brock, M.D.
• Rhonda Brock
• Terri Ann Brocki, RDN
• Michelle Broderick, CCC-SLP
• Shannon Nicole Broderick
• Samantha McLean Brodie, DPT
• Beth Anne Brodine
• Kenneth J Brodsky
• Stephen Michael Bronaugh, M.D.
• Jamitta Brooks-Covington, LCSW

• Social Worker in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.