Kimberly Anne Campbell, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

MC11117 Issued in NH

Practice address

10 Tsienneto Rd
Derry, NH 03038

Phone

(603) 434-1577

Fax

(603) 226-7508

NPI assigned

Sep 10, 2008

Last updated

Oct 1, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Mrs. Kimberly Anne Laberge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1326297763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TSIENNETO RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-434-1577",
            "fax_number": "603-226-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TSIENNETO RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-434-1577",
            "fax_number": "603-226-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC11117",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "1563",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "MC11117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432604999",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LABERGE",
            "middle_name": "ANNE",
            "prefix": "MRS.",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Byer, MD
• Kyle Cahill, OTR/L
• Stephen F. Caldwell, D.D.S., M.S.
• Thomas Call
• Gwendolyn Callahan
• Canvas Psychotherapy PLLC
• Capital Orthopedic Surgery Center, LLC (Orthopedic Surgery Center Derry)
• Jessica Rose Card, RDH
• Dianne Irene Cardinal, MA
• Caring Companions Home Care of New England LLC

• Clinical Social Worker in Derry, NH
• Providers in Derry, 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 Oct 1, 2014; 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.