Debra Candy Kimaiga, LCSW, LPC, ICS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1061-123 Issued in WI

Practice address

1717 Taylor Ave
Racine, WI 53403-2405

Phone

(262) 638-6744

Fax

(262) 638-6540

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1427117779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405",
            "telephone_number": "262-638-6744",
            "fax_number": "262-638-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405",
            "telephone_number": "262-638-6744",
            "fax_number": "262-638-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMAIGA",
        "first_name": "DEBRA",
        "middle_name": "CANDY",
        "credential": "LCSW, LPC, ICS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "605-125",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1061-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39617400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Robert B.H. Kim, MD MBA
• Kind Dentistry LLC
• Kimberly A Kind-Bauer, DDS
• Nathalie Anne King, PA
• Sherri King, RN
• Russell William Kinkade Jr., PSYD

• Clinical Social Worker in Racine, WI
• Providers in Racine, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.