Individual provider Active NPI

Kimberly Gaylor, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1508179946
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
108424 Issued in TX
Practice address
4700 McKinney Ave Apt 103
Dallas, TX 75205-3505
Phone
(214) 938-8812
NPI assigned
Jul 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 108424 TX Primary
Clinical Social Worker 1041C0700X 4360 OK

Addresses

Primary practice location

4700 McKinney Ave Apt 103
Dallas, TX 75205-3505

Mailing address

1025 Straka Ter
Oklahoma City, OK 73139-2544
Phone (214) 938-8812

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

State licenses

LicenseStateTypeSpecialty
108424TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1508179946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 STRAKA TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392544",
            "telephone_number": "214-938-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MCKINNEY AVE APT 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053505",
            "telephone_number": "214-938-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLOR",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "108424",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4360",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.