Kimberly Ruth Nicolson, DSW, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1840 S Elena Ave Ste 106
Redondo Beach, CA 90277-5716

Phone

(310) 737-2210

NPI assigned

Sep 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Ruth Ives Former name

Medicare fee-for-service enrollment

Enrolled in CA

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Mineset Mental Health Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Redondo Beach, CA
  • NPI 1972284669
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1164617015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 S ELENA AVE STE 106",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775716",
            "telephone_number": "310-737-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 S ELENA AVE STE 106",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775716",
            "telephone_number": "310-737-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLSON",
        "first_name": "KIMBERLY",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "DSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "62673",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "IVES",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Loan Ngoc Nguyen, PHARM D
• Mitchell Nguyen
• Tiffany Nguyen, DDS, MS
• Trung Nguyen
• Molly Beth Nickerson, MSW, ACSW
• Diana Flavia Nicorici, NP
• Kevin B Niehaus, MSE, PSYD, LPCC,
• Nilesh Patel D O Inc
• Nina J Lee Tall MD Inc
• Nina Le, D.D.S., Inc.

• Social Worker in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.