Individual provider Active NPI

Kimberly Stevens, MSW / LCSW

  • Clinical Social Worker
  • Richmond, KY
National Provider Identifier
1255674909
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5036 Issued in KY
Practice address
1043 Center Dr
Richmond, KY 40475-3838
Phone
(606) 548-0264
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5036 KY Primary
Social Worker 104100000X 5453 KY

Addresses

Primary practice location

1043 Center Dr
Richmond, KY 40475-3838

Mailing address

1043 Center Dr
Richmond, KY 40475-3838
Phone (606) 548-0264

Other practice location 1

440 Allen Ave
Morehead, KY 40351-1106
Phone (606) 548-0264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5453KYMDSocial Worker
5036KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Extended Care Specialists, Inc Clinical PastSince Oct 6, 2024 Accepting new patients

Organizations & group practices 1

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": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1255674909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 CENTER DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753838",
            "telephone_number": "606-548-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 CENTER DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753838",
            "telephone_number": "606-548-0264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Allen Ave",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403511106",
            "country_code": "US",
            "telephone_number": "606-548-0264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "MSW / LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "5036",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "5453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.