Kimberly Dawn Clemons, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

10468 Issued in TX

Practice address

1901 Dutton Dr
Suite E
San Marcos, TX 78666-7573

Phone

(512) 396-7695

Fax

(512) 396-7633

NPI assigned

Jul 2, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly Dawn Niznik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Hays Caldwell Council on Alcohol and Drugs

  • Addiction (Substance Use Disorder) Counselor
  • San Marcos, TX
  • NPI 1689977928

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1134569361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 DUTTON DR",
            "address_2": "SUITE E",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667573",
            "telephone_number": "512-396-7695",
            "fax_number": "512-396-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 DUTTON DR",
            "address_2": "SUITE E",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667573",
            "telephone_number": "512-396-7695",
            "fax_number": "512-396-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "10468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065337001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "NIZNIK",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christus Santa Rosa Health Care Corporation
• Christus Santa Rosa Outpatient Surgery - New Braunfels, LP
• City of San Marcos
• Barbara Jane Clark
• Marianne Paulos Clay II, N.P.
• Kathie Norfleet Cleveland, MA LPC LMFT
• Taylor Layne Cloy, APNP
• John D Cluley, M.D.
• Cobb Allergy Clinic of San Marcos
• Jeremy Cobb, ATC, LAT

• Addiction (Substance Use Disorder) Counselor in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.