Kimberly Bacik, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007196 Issued in CT

Practice address

900 Watertown Ave
Waterbury, CT 06708-2011

Phone

(203) 756-8984

NPI assigned

Feb 8, 2010

Last updated

Feb 8, 2010By 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

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Challenging Minds LLCGroup PAC ID 9830429794, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Challenging Minds LLC

  • Community/Behavioral Health Agency
  • Torrington, CT
  • NPI 1730745316
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1679805246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 LITCHFIELD RD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951018",
            "telephone_number": "860-417-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WATERTOWN AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082011",
            "telephone_number": "203-756-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACIK",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren K Ayr-Volta, PH.D.
• Ibraheim Ayub, DO
• Marjan Azin, MD
• B and L Pharmacy Inc (della pietra pharmacy)
• Amy Jennifer Bach, N.P.
• Alexander J Backus, DPT
• Christina Baden, APRN
• Sarah Baden
• Bags Foundation CT Inc
• Saudi Rio Baguio, P.T.

• Clinical Social Worker in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.