Individual provider Active NPI

Kimberly Millington-Joseph, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1750736914
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008836 Issued in NC
Practice address
6838 Silverwood LN
Charlotte, NC 28215-7010
Phone
(704) 607-4190
NPI assigned
Apr 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 C008836 NC Primary

Addresses

Primary practice location

6838 Silverwood LN
Charlotte, NC 28215-7010

Mailing address

6838 Silverwood LN
Charlotte, NC 28215-7010

Other practice location 1

1977 J N Pease Pl Ste 101
Charlotte, NC 28262-4528
Phone (704) 607-4190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C008836NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Place Counseling, PLLC Clinical CurrentSince Dec 29, 2024 Accepting new patients

Organizations & group practices 1

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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1750736914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6838 SILVERWOOD LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282157010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6838 SILVERWOOD LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282157010",
            "telephone_number": "704-607-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1977 J N Pease Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282624528",
            "country_code": "US",
            "telephone_number": "704-607-4190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLINGTON-JOSEPH",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.