Kimberly Shelton-Hudgins, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7436 Issued in MS

Practice address

218 5TH St S
Columbus, MS 39701-5730

Phone

(662) 368-8853

NPI assigned

Jan 31, 2008

Reactivated

Oct 13, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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 and National Provider Directory roles.

• KS Hudgins Professional Counseling and Consulting Group, LLC

  • Clinical Social Worker
  • Columbus, MS
  • NPI 1780314153

  Mental Health

  Medicare reassignment NPD Authorized official
• Kimila Deflanders LCSW LLC

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1588217699
  NPD (past)
• Region Seven Mental Health Idd Commission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, MS
  • NPI 1699891358
  NPD (past)

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1770761884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 29TH AVE STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395011945",
            "telephone_number": "228-220-4226",
            "fax_number": "228-220-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 5TH ST S",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397015730",
            "telephone_number": "662-368-8853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1390 29th Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395011945",
            "country_code": "US",
            "telephone_number": "228-220-4226",
            "fax_number": "228-220-4303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON-HUDGINS",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "deactivation_date": "2022-09-28",
        "reactivation_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "M7436",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Sharp, PT
• Misty T Sharp, M.D.
• Victoria Sharp
• Stefanie Lee Shaver, M.D.
• Virginia Shaw, NP
• Shepherd'S Touch Counseling Center
• Rachel Baden Sherrill, PH.D.
• Jennifer Denise Shields
• Kenyon Scott Shiflett
• Angela L Shine, BSW, LMSW

• Clinical Social Worker in Columbus, MS
• Providers in Columbus, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.