Kimberly Kay Anderson, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05940 Issued in IA

Practice address

2421 Coral Court
Suite #129
Coralville, IA 52241

Phone

(319) 322-8887

Fax

(319) 356-2587

NPI assigned

Jul 11, 2016

Sex

Female

Sole proprietor

Yes

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

Practice roles

Locations

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.

• De Novo Counseling & Therapy, LLC

  • Clinical Social Worker
  • Coralville, IA
  • NPI 1477423275
  NPD Authorized official

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1447602743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 CAMP CARDINAL BLVD",
            "address_2": "BOX 2271",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-594-8010",
            "fax_number": "319-356-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 CORAL COURT",
            "address_2": "SUITE #129",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-322-8887",
            "fax_number": "319-356-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "05940",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "05940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409321",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Amro, LMSW
• Ancera Psychology Associates PC
• Alexander Anderson, DC
• Brieanna Anderson, LMSW
• Kelsey Anderson, LISW, LCSW
• Kahlil Jihad Andrews, MD
• Zoe N Angus, MA, CF-SLP
• Anne M. Green, Inc.
• Adam John Arendt, D.P.M.
• Amber Aria, OD

• Clinical Social Worker in Coralville, IA
• Providers in Coralville, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.