Emma Grace Kimball, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CSW007836 Issued in GA

Practice address

1028 Saint Charles Ave NE Apt 1
Atlanta, GA 30306-4227

Phone

(770) 634-9699

NPI assigned

Jul 7, 2022

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

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1740913508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 SAINT CHARLES AVE NE APT 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 SAINT CHARLES AVE NE APT 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064227",
            "telephone_number": "770-634-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "EMMA",
        "middle_name": "GRACE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "CSW007836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yong Kyun Kim
• Yoo Mee Kim, DDS
• Youngki Kim, LAC
• Grace Alexandra Kimani, M.D.
• Yolanda Muthoni Kimani, NP
• John W Kimbell, PAAA
• Lauren Lydia Kimbell, D.C.
• Kimberley E. Wilson, LLC
• Kimberly Smiley, Psy.D., LLC
• Kimberly the Dietitian, LLC

• Mental Health Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.