Kim Denise Williams-Jenkins, LCSWR,CASAC,CRC,MSED

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

077058-R Issued in NY

Practice address

15 1St St FL 2
Staten Island, NY 10306-2201

Phone

(917) 613-4009

Fax

(718) 448-3571

NPI assigned

May 12, 2008

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

• Kim Denise Williams Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

New York University Medical College - NLG, 2005

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.

• Culturally Competent Compassionate Counseling LCSW PLLC

  • Clinical Social Worker
  • Staten Island, NY
  • NPI 1669805602
  Medicare reassignment NPD
• Victory Behavioral Health Inc

  • Clinical Child & Adolescent Psychologist
  • Staten Island, NY
  • NPI 1881601466
  NPD (past)

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1184891897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 1ST ST FL 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062201",
            "telephone_number": "917-613-4009",
            "fax_number": "718-448-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 1ST ST FL 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062201",
            "telephone_number": "917-613-4009",
            "fax_number": "718-448-3571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-JENKINS",
        "first_name": "KIM",
        "middle_name": "DENISE",
        "credential": "LCSWR,CASAC,CRC,MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "12039",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077058-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "WILLIAMS",
            "middle_name": "DENISE",
            "credential": "M.S.ED",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William F. Edwards DDS PC
• William Tursi, M.D., PLLC
• Williams Eye Works, Inc
• Williams Financial Solutions
• Cabilia E Williams-Cheng, MD
• Amanda Deloris Williams
• Bethany Williams, MD
• Carolyn Rachel Williams
• Chinequia Tyann Williams, MSW
• Christopher Williams, OPTICIAN

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.