Kimberly Russell Hayes, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005359 Issued in NC

Practice address

314 N Highland St
Gastonia, NC 28052-2108

Phone

(704) 567-8690

Fax

(704) 536-6030

NPI assigned

Jul 18, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Melange Health Solutions, LLC

  • Mental Health Counselor
  • Gastonia, NC
  • NPI 1184995813
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1124047535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 TRAIL RIDGE CT",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280568590",
            "telephone_number": "704-574-7808",
            "fax_number": "704-536-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 N HIGHLAND ST",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280522108",
            "telephone_number": "704-567-8690",
            "fax_number": "704-536-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "KIMBERLY",
        "middle_name": "RUSSELL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "E4158-B0775",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14248",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106457",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roberta J Hawk, MD
• Joyce G Hawkins, RN
• Rebekah J Hawkins
• Evan Nicholas Hayden, PMHNP-BC
• Douglas Hayes, ATC
• Marianne Hayes, FNP
• Shayla J Hayes, OTR/L
• William Clayton Hayes Jr., M.D.
• Joy M Hays, OT
• Hcoc CMG LLC

• Clinical Social Worker in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.