Individual provider Active NPI

Kimberly Lynn Reevas, MSW, LCSW

  • Clinical Social Worker
  • Chesterton, IN
National Provider Identifier
1619071651
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004617A Issued in IN
Practice address
119 Broadway Ste 102
Chesterton, IN 46304-2477
Phone
(317) 679-2895
NPI assigned
Sep 11, 2006
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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 34004617A IN Primary
Clinical Social Worker 1041C0700X 149010118 IL

Addresses

Primary practice location

119 Broadway Ste 102
Chesterton, IN 46304-2477

Mailing address

1810 Briam Dr
Valparaiso, IN 46383-1151
Phone (317) 679-2895

Other names 1

  • Ms. Kimberly Lynn Reevas Professional name

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
149010118ILMDClinical Social Worker
34004617AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly Reevas, LLC Current Accepting new patients
Oaklawn Psychiatric Center, Inc. Past Accepting new patients

Locations

20500 S Lagrange Rd
Ste 200S
Frankfort, IL 60423
Phone (574) 904-8552

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1619071651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BRIAM DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463831151",
            "telephone_number": "317-679-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BROADWAY STE 102",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042477",
            "telephone_number": "317-679-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVAS",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004617A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "REEVAS",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "MSW, LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.