Active NPI
Kimberly Corcoran, MSW
- Clinical Social Worker
- Kissimmee, FL
National Provider Identifier
1821379256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW 3905
- Practice address
- 2206 Jessa Dr
Kissimmee, FL 34743-3301 - Phone
- (407) 350-5486
- NPI assigned
- Aug 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW 3905 | FL | Primary |
Addresses
Primary practice location
2206 Jessa Dr
Kissimmee, FL 34743-3301
Mailing address
2206 Jessa Dr
Kissimmee, FL 34743-3301
Phone (407) 350-5486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ISW 3905 | Other | FL | REGISTERED CLINICAL SOCIAL WORKER INTERN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ISW 3905 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1821379256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2206 JESSA DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347433301",
"telephone_number": "407-350-5486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2206 JESSA DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347433301",
"telephone_number": "407-350-5486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORCORAN",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "ISW 3905",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED CLINICAL SOCIAL WORKER INTERN",
"identifier": "ISW 3905",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.