Kam Virtual Therapeutic Services Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KAM VIRTUAL THERAPEUTIC SERVICES INC

Practice address

11266 Lake Mandarin Cir E
Jacksonville, FL 32223-7811

Phone

(904) 705-6130

NPI assigned

Jul 24, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Kelly Ann Minor, LCSW

Title

President

Phone

(904) 720-2090

Specialties & licenses 1

Addresses

Other names 1

• KAM Virtual Doing business as

Locations

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1205445327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7643 GATE PKWY STE 104-941",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562893",
            "telephone_number": "904-720-2090",
            "fax_number": "904-490-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11266 LAKE MANDARIN CIR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237811",
            "telephone_number": "904-705-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAM VIRTUAL THERAPEUTIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-24",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "MINOR",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-720-2090",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAM Virtual",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KAM Virtual",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sahana R Kalmadi, MD
• Aastha Kalra, DO
• Scott L Kaltman, MD
• Lara R Kalush
• Piotr Kaluza, PT
• Mustafa Kamal
• Sandy Ben Kamanda
• Sia Kamanda, LPN
• Kadiah Kamara
• Vikeerna Kamatgi, MD

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.