Kimberly Clemmons, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61507239 Issued in WA

Practice address

505 S 4TH Ave
Yakima, WA 98902-3547

Phone

(509) 575-4084

NPI assigned

Aug 6, 2018

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 names 1

• Kimberly Clemmons Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1790263226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989070959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023547",
            "telephone_number": "509-575-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "KIMBERLY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61507239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CLEMMONS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carolynn Kathleen Clarke, CNM, MSN, RN
• Kirsten Oversby Clarke, DPT
• Sean F Cleary, MD
• Michael Clement, MS, CDP
• Amanda Cathleen Clemmons, PA-C
• Clinic for Ear Nose Throat Head & Neck Medicine & Surgery P S
• Alyssa Closner, RN
• Courtney A Cobane, OT
• Caroline Cobb, ARNP
• Zachary Tyrus Cobb, RN

• Clinical Social Worker in Yakima, WA
• Providers in Yakima, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.