Individual provider Active NPI

Kimberly Reese, MSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1487978078
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007472 Issued in NC
Practice address
7810 Pineville Matthews Rd Ste 5
Charlotte, NC 28226-5300
Phone
(704) 426-3419
Fax
(704) 980-7662
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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 C007472 NC Primary

Addresses

Primary practice location

7810 Pineville Matthews Rd Ste 5
Charlotte, NC 28226-5300

Mailing address

10617 Prairie Ridge LN
Charlotte, NC 28213-4811
Phone (704) 426-3419

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": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1487978078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10617 PRAIRIE RIDGE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282134811",
            "telephone_number": "704-426-3419",
            "fax_number": "704-980-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 PINEVILLE MATTHEWS RD STE 5",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265300",
            "telephone_number": "704-426-3419",
            "fax_number": "704-980-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "KIMBERLY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.