Kimberly Walker

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21378 Issued in AZ

Practice address

1695 Mesquite Ave Ste 216
Lake Havasu City, AZ 86403-5688

Phone

(928) 453-0404

Fax

(928) 855-2778

NPI assigned

Apr 7, 2023

Last updated

Feb 22, 2024By the provider in NPPES

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 AZ

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Havasu Behavioral Health LLCGroup PAC ID 3971945767, 2 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Havasu Behavioral Health, LLC

  • Clinical Social Worker
  • Lake Havasu City, AZ
  • NPI 1033764097
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1215622931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 MESQUITE AVE STE 216",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035688",
            "telephone_number": "928-453-0404",
            "fax_number": "928-855-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 MESQUITE AVE STE 216",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035688",
            "telephone_number": "928-453-0404",
            "fax_number": "928-855-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "21378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vision Care Center
• Emily E Vona, FNP-C
• W Milyani MD PLLC (Frontier Skin and Cancer)
• Wal-Mart Store, Inc. (Vision Center 30-1364)
• Walgreen Co (Walgreens #05208)
• Matthew Wallender, PTA
• Walmart Inc. (Walmart Pharmacy 10-1364)
• Sandy Walters, RN
• Kelli M Ward, D.O.
• Shannon Ward, LPN

• Clinical Social Worker in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.