Active NPI
Kimberly Donnielle Wheeler, LCSW-C
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1396089421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW017515
- Practice address
- 234 Bainbridge St
Apt 1R
Philadelphia, PA 19147-2323 - Phone
- (443) 851-8258
- NPI assigned
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 15226 | MD | |
| Clinical Social Worker | 1041C0700X | CW017515 | PA | Primary |
Addresses
Primary practice location
234 Bainbridge St
Apt 1R
Philadelphia, PA 19147-2323
Mailing address
234 Bainbridge St
Apt 1R
Philadelphia, PA 19147-2323
Phone (443) 851-8258
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15226 | MD | MD | Clinical Social Worker |
| CW017515 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354147200000",
"number": "1396089421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 BAINBRIDGE ST",
"address_2": "APT 1R",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191472323",
"telephone_number": "443-851-8258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 BAINBRIDGE ST",
"address_2": "APT 1R",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191472323",
"telephone_number": "443-851-8258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "KIMBERLY",
"middle_name": "DONNIELLE",
"name_prefix": "Miss",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "15226",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW017515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.