Kira Baskerville-Williams, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05189700 Issued in NJ

Practice address

2130 Millburn Ave
Ste D-2
Maplewood, NJ 07040-3725

Phone

(973) 801-1801

Fax

(908) 964-0809

NPI assigned

Oct 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Evolution Mind, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Maplewood, NJ
  • NPI 1912428905
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1336699529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE",
            "address_2": "STE D-2",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403725",
            "telephone_number": "973-801-1801",
            "fax_number": "908-964-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE",
            "address_2": "STE D-2",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403725",
            "telephone_number": "973-801-1801",
            "fax_number": "908-964-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASKERVILLE-WILLIAMS",
        "first_name": "KIRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05189700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aunjuli a. Hicks LPC Limited Liability Company (Hicks Group: Wellness Center)
• Avedamed LLC
• Kalavathi Ayyagari, M.D.
• Kamalakar R. Ayyagari, M.D.
• Shobha Ayyappan, MS, LPC
• Ruby Baskerville, LCSW
• Bass Family Chiropractic, PC
• Michelle Bass, LCSW
• Wayne Jonathan Bass, DC
• Catherine Bataille, M.S.W.

• Clinical Social Worker in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.