Individual provider Active NPI

Kimberlee A Worth, LCSW

  • Mental Health Counselor
  • Peabody, MA
National Provider Identifier
1376791046
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
118255 Issued in MA
Practice address
1R Newbury St
Ste 207
Peabody, MA 01960-3816
Phone
(781) 913-2324
Fax
(888) 616-2623
NPI assigned
Sep 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 118255 MA Primary

Addresses

Primary practice location

1R Newbury St
Ste 207
Peabody, MA 01960-3816

Mailing address

1R Newbury St
Ste 207
Peabody, MA 01960-3816
Phone (781) 913-2324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20160615002506 MA Practitioner - Clinical Social Worker 3971894346 Practice locations: Beverly, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Cummings Ctr
Suite 207P
Beverly, MA 01915-6104
Phone (781) 913-2324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1376791046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1R NEWBURY ST",
            "address_2": "STE 207",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603816",
            "telephone_number": "781-913-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1R NEWBURY ST",
            "address_2": "STE 207",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603816",
            "telephone_number": "781-913-2324",
            "fax_number": "888-616-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTH",
        "first_name": "KIMBERLEE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "118255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.