Kimberly Becker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3167 Issued in KY

Practice address

1002 N Mulberry St Ste 100
Elizabethtown, KY 42701-2037

Phone

(207) 307-3276

NPI assigned

Jun 3, 2006

Last updated

Oct 9, 2024By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

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, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kim Sego Tully, LCSW, Psychotherapy Services

  • Clinical Social Worker
  • Elizabethtown, KY
  • NPI 1811231897
  Medicare reassignment
• Communicare Inc

  • Community/Behavioral Health Agency
  • Springfield, KY
  • NPI 1083751424
  NPD (past)
• Communicare Inc

  • Community/Behavioral Health Agency
  • Bardstown, KY
  • NPI 1679610117
  NPD (past)
• Communicare Inc

  • Community/Behavioral Health Agency
  • Hodgenville, KY
  • NPI 1821419789
  NPD (past)
• Communicare Inc

  • Community/Behavioral Health Agency
  • Elizabethtown, KY
  • NPI 1891832234
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1760420459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 RUE LA GRANDE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013135",
            "telephone_number": "270-307-3672",
            "fax_number": "253-681-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N MULBERRY ST STE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012037",
            "telephone_number": "207-307-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11574939",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000495963",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30605018",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Care LLC
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• Clinical Social Worker in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.