Kim Wasley LCSW LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

KIM WASLEY LCSW LLC

Practice address

598 S Milledge Ave Ste 5
Athens, GA 30605-1262

Phone

(706) 522-3017

NPI assigned

Jul 30, 2024

Organization subpart

No

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

Authorized official

Name

Kimberly Wasley, LCSWNPI 1598239964

Title

Owner

Phone

(706) 974-9065

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kim Wasley, LCSW, LLC Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Wasley, LCSW

  • Clinical Social Worker
  • Athens, GA
  • NPI 1598239964
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1154150019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 ALPS RD",
            "address_2": "SUITE 2, PMB 196",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-974-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 S MILLEDGE AVE STE 5",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306051262",
            "telephone_number": "706-522-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM WASLEY LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "WASLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-974-9065",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598239964",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kim Wasley, LCSW, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth K Kilgore, NP
• Maureen R Killeen, CNS
• Erin Boyer Kilzi, PAC
• Joseph Kilzi, PA
• Kim F Turner M Ed LPC
• John Hong-Chul Kim, D.D.S.
• Rebecca A.S. Kim, LPC
• Kelby Kimball
• Kimberly Walpert, M.D., LLC
• Ashlee R Kimbrell, M.D.

• Adult Mental Health Clinic/Center in Athens, GA
• Providers in Athens, GA by specialty
• Adult Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.