Individual provider Active NPI

Kimberly R Saunders, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1427495852
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008011 Issued in VA
Practice address
297 Independence Blvd
Ste 312
Virginia Beach, VA 23462-2911
Phone
(757) 385-0511
Fax
(757) 473-5161
NPI assigned
May 24, 2013
Last updated
May 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904008011 VA Primary

Addresses

Primary practice location

297 Independence Blvd
Ste 312
Virginia Beach, VA 23462-2911

Mailing address

734 Driskill CT
Virginia Beach, VA 23464-2130
Phone (757) 523-1061

Other identifiers 1

IdentifierTypeStateIssuer
1861562472MedicaidVA

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1427495852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 DRISKILL CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234642130",
            "telephone_number": "757-523-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 INDEPENDENCE BLVD",
            "address_2": "STE 312",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622911",
            "telephone_number": "757-385-0511",
            "fax_number": "757-473-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861562472",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.