Kimberly Scott, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004666 Issued in NC

Legal business name

KIMBERLY SCOTT, PLLC

Practice address

112 Brooks St
Wake Forest, NC 27587-2757

Phone

(919) 324-7361

NPI assigned

Jun 17, 2015

Organization subpart

No

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

Authorized official

Name

Kimberly Scott, LCSWNPI 1093884108

Title

Director

Phone

(919) 414-3452

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Antoine Scott, LCSW

  • Clinical Social Worker
  • Wake Forest, NC
  • NPI 1093884108
  NPD (past) Authorized official

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1790166593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BROOKS ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872757",
            "telephone_number": "919-324-7361",
            "fax_number": "919-640-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BROOKS ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872757",
            "telephone_number": "919-324-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY SCOTT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-414-3452",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002801",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nancy E King, M.S., O.T.
• Nicole King, LCSW

• Clinical Social Worker in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.