Individual provider Active NPI

Kaara Defreitas Kiddoe, M.S.W.

  • Clinical Social Worker
  • Palmetto Bay, FL
National Provider Identifier
1326577644
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW11624 Issued in FL
Practice address
14401 Old Cutler Rd
Palmetto Bay, FL 33158-1722
Phone
(786) 573-7010
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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 ISW11624 FL Primary

Addresses

Primary practice location

14401 Old Cutler Rd
Palmetto Bay, FL 33158-1722

Mailing address

10736 SW 118TH PL
Miami, FL 33186-3955
Phone (919) 408-9319

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
ISW11624FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Counseling, Inc. Clinical PastSince Feb 28, 2014 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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1326577644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10736 SW 118TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331863955",
            "telephone_number": "919-408-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14401 OLD CUTLER RD",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331581722",
            "telephone_number": "786-573-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDOE",
        "first_name": "KAARA",
        "middle_name": "DEFREITAS",
        "name_prefix": "Mrs.",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW11624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.