Individual provider Active NPI

Kimberly Williams, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1205348240
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64744 Issued in TX
Practice address
2777 N Stemmons Fwy
Dallas, TX 75207-2277
Phone
(214) 456-7200
NPI assigned
Oct 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 64744 TX Primary

Addresses

Primary practice location

2777 N Stemmons Fwy
Dallas, TX 75207-2277

Mailing address

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (844) 856-6926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20180109000836 TX Practitioner - Clinical Social Worker 3476812900 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64744TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc Current Accepting new patients
Complex Care Medical Services Corporation Past Accepting new patients

Locations

1935 Medical District Dr
#908
Dallas, TX 75235

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

7211 Preston Rd
Ste 1200
Plano, TX 75024
Phone (469) 303-3000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1205348240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "844-856-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 N STEMMONS FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752072277",
            "telephone_number": "214-456-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.