Individual provider Active NPI

Deborah Kimbler, L.C.S.W.

  • Clinical Social Worker
  • Sarasota, FL
National Provider Identifier
1649514563
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 13781 Issued in FL
Practice address
1451 10TH St
Sarasota, FL 34236-4048
Phone
(941) 331-2530
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 13781 FL Primary

Addresses

Primary practice location

1451 10TH St
Sarasota, FL 34236-4048

Mailing address

1565 State St
Sarasota, FL 34236-5808
Phone (941) 331-2530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018000731 FL Practitioner - Clinical Social Worker 4082902424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gulf Coast PsychotherapyGroup PAC ID 0941468011, 8 clinicians

Practice addresses (Care Compare)

4167 Clark Rd
Suite 3
Sarasota, FL 34233-2403
Phone (941) 219-3111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 13781FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center of Revitalizing Psychiatry, P.C. CurrentSince Jan 31, 2023 Accepting new patients
Gulf Coast Psychotherapy Clinical CurrentSince Mar 1, 2023 Accepting new patients
Center of Revitalizing Psychiatry PC PastSince Jan 31, 2023 Accepting new patients
Awesome Minds Psychiatric LLC Past Accepting new patients

Locations

4167 Clark Rd
Unit 3
Sarasota, FL 34233
Phone (941) 219-3111

2033 Wood St
Ste 220
Sarasota, FL 34237
Phone (941) 677-3366

4167 Clark Rd
Sarasota, FL 34233
Phone (941) 219-3111

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1649514563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 STATE ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365808",
            "telephone_number": "941-331-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 10TH ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342364048",
            "telephone_number": "941-331-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLER",
        "first_name": "DEBORAH",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 13781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.