Kimberly A Mahoney

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09926768 Issued in CO

Practice address

1301 E 7TH St
Pueblo, CO 81001-3508

Phone

(719) 543-8711

Fax

(719) 543-0171

NPI assigned

Apr 29, 2010

Last updated

Feb 1, 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 3

Addresses

Other identifiers 2

Other names 1

• Kimberly A Hartman Former name

Medicare fee-for-service enrollment

Enrolled in CO

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Colorado Counseling and Wellness, PLLCGroup PAC ID 2466838693, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.hartmanmahoney.p1@direct.pueblochc.nextgenshare.com

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.

• Southern Colorado Counseling and Wellness. PLLC

  • Clinical Psychologist
  • Pueblo, CO
  • NPI 1396464392

  Mental Health

  Medicare reassignment Care Compare group NPD
• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1770529950
  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  CO

  Medicare reassignment NPD
• Health Solutions

  dba Health Solutions Main

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pueblo, CO
  • NPI 1033165527
  Medicare reassignment
• Health Solutions

  dba Respite

  • Respite Care
  • Pueblo, CO
  • NPI 1184475121
  NPD
• Health Solutions

  dba Health Solutions Crestone Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pueblo, CO
  • NPI 1639427255
  NPD
• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1316466816
  NPD
• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1952071219
  NPD

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1235456393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E 7TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810013508",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-0171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Charlie Hall Blvd",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145832",
            "country_code": "US",
            "telephone_number": "843-852-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-29",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "9376",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000190485",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HARTMAN",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Magnolia Medical Aesthetics, PLLC (Pueblo Primary Care Clinic)
• Krishna Chandra Mahat, M.D.
• Faisal Mahfooz, MD
• Fernando Ariel Mahmoud, M.D.
• Vincent Ahmed Mahmoud, MS, BCBA, IBA
• Nicolle Mainthow
• Rachel Maksimowicz, ATC
• Holly Maloy, M.D.
• Seana Marie Maltezo, NP
• Aruniti Manawa, DO

• Clinical Social Worker in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.