Kim C. Till, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27713 Issued in CA

Practice address

5 Mareblu
Aliso Viejo, CA 92656-3014

Phone

(949) 643-6900

NPI assigned

Oct 3, 2006

Last updated

Nov 19, 2019By 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 1

Addresses

Other names 1

• Ms. Kim Catherine Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1558455295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12404",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926278268",
            "telephone_number": "949-643-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MAREBLU",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563014",
            "telephone_number": "949-643-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "KIM",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "SMITH",
            "middle_name": "CATHERINE",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jane Elizabeth Teixeira, LMFT
• Michael James Tejano, PT DPT
• Alexander Thermos, D.O., D.C.
• Thomas Ludema MD
• Patrick S Thompson, MD
• Timothy Robert Miller, M.D., Inc.
• Chitra Tiruveedula, BDS,DDS
• Larissa Todd
• Tetyana Tomiuk
• Tony Beizaee DMD Apdc (Aliso Creek Denal)

• Clinical Social Worker in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.