Kimberly Nathaly Anaya, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW89750 Issued in CA

Practice address

155 W Hospitality LN Ste 245
San Bernardino, CA 92408-3318

Phone

(909) 939-5007

NPI assigned

Feb 9, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Theraville Counseling Services, a LCSW Corporation

  • Clinical Social Worker
  • San Bernardino, CA
  • NPI 1366084360

  Clinical

  NPD (past)

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581206400000",
    "number": "1346872207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 VAIL LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072984",
            "telephone_number": "661-361-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W HOSPITALITY LN STE 245",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083318",
            "telephone_number": "909-939-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANAYA",
        "first_name": "KIMBERLY",
        "middle_name": "NATHALY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-09",
        "last_updated": "2020-02-09",
        "certification_date": "2020-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW89750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl Amparo, NP
• Ample Joy ABA Consulting Services
• Amrik Transit Group
• Toni Marie Amundsen, CNM
• Colby Anastacio
• Anchor Medical Group
• Angela Genene Anderson
• Bradley P Anderson, MA
• Dennis Kent Anderson, M.D.
• Hannah Anderson, MD

• Clinical Social Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2020; 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.