Kimberly Gereda Psychotherapy & Self-Care

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007676 Issued in CT

Legal business name

KIMBERLY GEREDA PSYCHOTHERAPY & SELF-CARE

Practice address

59 Elm St
Suite #500
New Haven, CT 06510-2047

Phone

(203) 525-4272

NPI assigned

Sep 26, 2016

Organization subpart

No

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

Authorized official

Name

Kimberly Gereda, LCSW

Title

Owner of Practice

Phone

(203) 525-4272

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly J Marganski, LCSW

  • Clinical Social Worker
  • New Haven, CT
  • NPI 1407208358
  NPD (past)

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1477002889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ELM ST",
            "address_2": "SUITE #500",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102047",
            "telephone_number": "203-525-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ELM ST",
            "address_2": "SUITE #500",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102047",
            "telephone_number": "203-525-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY GEREDA PSYCHOTHERAPY & SELF-CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "GEREDA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER OF PRACTICE",
        "authorized_official_telephone_number": "203-525-4272",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008067075",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soorin Kim, MD
• Timothy Taeho Kim, MD
• Yong Jae Kim, PHARMD
• Kimberlee J. Sass, PH.D., P.C. (Connecticut Neuropsychology, P.C.)
• Kimberly Ali, LLC
• Thomas Andrew Kimberly, APRN, MSN
• Kerry Kimmel
• Idil Kina, M.D.
• Barbara Kinder, MD
• Caroline Grace King

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.