Kimberly H Brenner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23691 Issued in TX

Practice address

222 S Prospect Ave FL 3
Park Ridge, IL 60068-4037

Phone

(915) 491-5709

NPI assigned

Jul 27, 2006

Last updated

Dec 20, 2024By the provider in NPPES

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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• FM Coaching & Counseling LLC

  • Clinical Social Worker
  • El Paso, TX
  • NPI 1740427384
  NPD (past) Authorized official
• Evolution From Within, P.C.

  • Clinical Social Worker
  • El Paso, TX
  • NPI 1477892339
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1508870759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9610 FRANKLIN AVE APT 518",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601312793",
            "telephone_number": "915-491-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S PROSPECT AVE FL 3",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684037",
            "telephone_number": "915-491-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "KIMBERLY",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "23691",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "32691",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0073KM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32449033",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "515889",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "555122000",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159603301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl S. Braun, M.D.
• Ryan Michael Braun, M.D.
• Harold Bregman, M.D.
• Elizabeth Ann Brennan, SLP
• Maura Brennan, M.D.
• James R Bresch, M.D.
• Dyanne Cynthia Bresler, LCPC
• Brickton Dental Clinic LLC
• Jameela Bridges
• Bridgeway Behavioral Health LLC

• Clinical Social Worker in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.