Kimberly Sun Mueller, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1881 Issued in NH

Practice address

4 Bicentennial SQ Unit 2a
Concord, NH 03301-4069

Phone

(808) 234-4777

NPI assigned

Mar 30, 2010

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NH

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

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 and National Provider Directory roles.

• Karma Burn Healing Therapies, LLC

  • Clinical Social Worker
  • Concord, NH
  • NPI 1770291544
  Medicare reassignment NPD Authorized official
• Bicentennial Square Counseling Associates, PLLC

  • Clinical Psychologist
  • Concord, NH
  • NPI 1083765184
  NPD (past)

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1285959536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 508",
            "city": "CONTOOCOOK",
            "state": "NH",
            "postal_code": "032290508",
            "telephone_number": "808-234-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BICENTENNIAL SQ UNIT 2A",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033014069",
            "telephone_number": "808-234-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "KIMBERLY",
        "middle_name": "SUN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13612755",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3101859",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1285959536",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "KBHTLLC",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jena P Mottola
• Elizabeth Ceona Moulton, PSYD
• Natalia Movila, BCBA
• Corey Mozisek
• Patricia A Mozzillo, CRNA
• Sevignee Mugisha, MSW
• Monika Muise, MS
• Christopher Brian Mulcahy, MLADC
• Kathryn Mullaney
• Eliza Mullen

• Clinical Social Worker in Concord, NH
• Providers in Concord, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.