Active NPI
Kimberly L. Bean, LCSW, CADC
- Clinical Social Worker
- Madison, WI
National Provider Identifier
1508822396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3671-123
- Practice address
- 7617 Mineral Point Rd
Ste 300
Madison, WI 53717-1623 - Phone
- (608) 833-9290
- Fax
- (608) 833-9691
- NPI assigned
- Apr 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3671-123 AND 1377 | WI | |
| Clinical Social Worker | 1041C0700X | 3671-123 | WI | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1377-132 | WI |
Addresses
Primary practice location
7617 Mineral Point Rd
Ste 300
Madison, WI 53717-1623
Mailing address
7617 Mineral Point Rd
Ste 300
Madison, WI 53717-1623
Phone (608) 833-9290
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 391627035010 | Other | WI | BLUE CROSS/BLUE SHIELD |
| 39241700 | Medicaid | WI | |
| 12020 | Other | WI | DEAN HEALTH PLAN |
| 999003778 | Other | WI | WPS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1377-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 3671-123 | WI | MD | Clinical Social Worker |
| 3671-123 AND 1377 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295395200000",
"number": "1508822396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7617 MINERAL POINT RD",
"address_2": "STE 300",
"city": "MADISON",
"state": "WI",
"postal_code": "537171623",
"telephone_number": "608-833-9290",
"fax_number": "608-833-9691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7617 MINERAL POINT RD",
"address_2": "STE 300",
"city": "MADISON",
"state": "WI",
"postal_code": "537171623",
"telephone_number": "608-833-9290",
"fax_number": "608-833-9691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAN",
"first_name": "KIMBERLY",
"middle_name": "L.",
"name_prefix": "Ms.",
"credential": "LCSW, CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-21",
"last_updated": "2011-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "3671-123 AND 1377",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "3671-123",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "1377-132",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "391627035010",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39241700",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN",
"identifier": "12020",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS",
"identifier": "999003778",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.