Kimberley B. Charles, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14558 Issued in FL

Practice address

3825 Henderson Blvd Ste 405
Tampa, FL 33629-5012

Phone

(813) 610-8378

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1639791544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14910 N DALE MABRY HWY # 340801",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HENDERSON BLVD STE 405",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295012",
            "telephone_number": "813-610-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "KIMBERLEY",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@flourishnowcc.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "address_1": "3825 Henderson Blvd Ste 405",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336295012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philomene Charles-Doristin, RN
• Deborah Metellus Charles, LCSW
• Dillion Kyle Charles
• Jennifer Charles, RBT
• Jodea A Charles, PA-C
• Mary Wampler Charles, PA-C
• Medelina Charles
• Nancy Madell Charles, MS CCCSLP
• Sharon Charles, APRN
• Stanley Charles

• Clinical Social Worker in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.