Kimila R. Deflanders, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7961 Issued in MS

Practice address

1390 29TH Ave Ste B
Gulfport, MS 39501-1945

Phone

(601) 557-2185

Fax

(228) 220-4303

NPI assigned

Jun 10, 2006

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

Medicare fee-for-service enrollment

Enrolled in MS

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Kimila Deflanders LCSW LLC

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1588217699

  Clinical, MS

  Medicare reassignment NPD Authorized official
• Premier Professional Counseling Services, LLC

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1750878781

  Clinical

  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1194767889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 VETERANS AVE",
            "address_2": "SOCIAL WORK SERVICE #122",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312410",
            "telephone_number": "228-523-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 29TH AVE STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395011945",
            "telephone_number": "601-557-2185",
            "fax_number": "228-220-4303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Veterans Ave",
            "address_2": "Social Work Service #122",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395312410",
            "country_code": "US",
            "telephone_number": "228-523-5000 x5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFLANDERS",
        "first_name": "KIMILA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deja Dedeaux
• Jillian R Dedeaux, CSFA
• Michelle A Dedeaux
• Banita Tarrelle Dees
• Courtney Simone Deflanders-Griffin, LPC, NCC, NSCS
• Glen Deitrick, C.R.N.A
• Nathan Daniel Dejager, SURFACE IDC
• Tiara Dela Cruz
• Braleigh Delaney
• Taylor Delk

• All providers in Gulfport, MS
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.