Individual provider Active NPI

Kimberly Burns, LCSW

  • Clinical Social Worker
  • Saint Peters, MO
National Provider Identifier
1275532913
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004576 Issued in MO
Practice address
150 Saint Peters Centre Blvd Ste B
Saint Peters, MO 63376-1653
Phone
(636) 345-4744
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 004576 MO Primary

Addresses

Primary practice location

150 Saint Peters Centre Blvd Ste B
Saint Peters, MO 63376-1653

Mailing address

150 Saint Peters Centre Blvd Ste B
Saint Peters, MO 63376-1653
Phone (636) 345-4744

Other names 1

  • Kimberly Killian Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
004576MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rcsquared Enterprises, LLC Clinical CurrentSince Oct 1, 2023 Accepting new patients

Locations

150 Saint Peters Centre Blvd
Ste B
Saint Peters, MO 63376
Phone (314) 930-3520

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1275532913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SAINT PETERS CENTRE BLVD STE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761653",
            "telephone_number": "636-345-4744",
            "fax_number": "636-244-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SAINT PETERS CENTRE BLVD STE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761653",
            "telephone_number": "636-345-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "004576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KILLIAN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.