Individual provider Active NPI

Kimberly Brooke Karr, LCSW

  • Clinical Social Worker
  • Rockwall, TX
National Provider Identifier
1780347963
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57902 Issued in TX
Practice address
500 Turtle Cove Blvd Ste 101
Rockwall, TX 75087-5300
Phone
(972) 865-8782
Fax
(972) 499-6935
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 57902 TX Primary

Addresses

Primary practice location

500 Turtle Cove Blvd Ste 101
Rockwall, TX 75087-5300

Mailing address

500 Turtle Cove Blvd Ste 101
Rockwall, TX 75087-5300
Phone (972) 865-8782

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
57902TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1780347963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 TURTLE COVE BLVD STE 101",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875300",
            "telephone_number": "972-865-8782",
            "fax_number": "972-499-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TURTLE COVE BLVD STE 101",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875300",
            "telephone_number": "972-865-8782",
            "fax_number": "972-499-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARR",
        "first_name": "KIMBERLY",
        "middle_name": "BROOKE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.