Kimberly D Farouki, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006395A Issued in IN

Practice address

3512 Stellhorn Rd
Fort Wayne, IN 46815

Phone

(260) 483-9081

Fax

(260) 483-9196

NPI assigned

Mar 30, 2012

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Community Howard Regional Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kokomo, IN
  • NPI 1881947133
  Medicare reassignment NPD
• Insight Therapeutic Services LLC.

  • Marriage & Family Therapist
  • Carmel, IN
  • NPI 1144741349

  Clinical

  Medicare reassignment NPD
• Extended Care Specialists, Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1669873733

  Clinical

  NPD (past)
• Gilead House, Inc.

  • Adult Mental Health Clinic/Center
  • Kokomo, IN
  • NPI 1194218024
  NPD (past)

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1689940942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392552",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519550",
            "telephone_number": "512-575-8028",
            "fax_number": "512-772-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46815",
            "telephone_number": "260-483-9081",
            "fax_number": "260-483-9196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5550 Sandstone Ave",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469018853",
            "country_code": "US",
            "telephone_number": "765-459-3891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5550 Sandstone Ave",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469018853",
            "country_code": "US",
            "telephone_number": "765-459-3891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAROUKI",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006395A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Farnsworth
• Kent Farnsworth, MD
• Beth Farny, SLP
• Samantha Faron, MSW
• Ibad Ui-Haq Farooqui, MD
• Terri Yvonne Farr, RN
• Laury Farrell, FNP
• Shannon Farrell, AU.D., CCC-A
• Farrington Specialty Counseling Inc.
• Brooke Farrington, MSW, LCSW, CEDS-S

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.