Individual provider Active NPI

Kimberly Sue Maffei, MSW, LCSW

  • Clinical Social Worker
  • Laramie, WY
National Provider Identifier
1841687233
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-1114 Issued in WY
Practice address
2020 E Grand Ave Ste 409
Laramie, WY 82070-4383
Phone
(307) 399-0435
NPI assigned
Apr 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 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 Worker 1041C0700X LCSW-1114 WY Primary

Addresses

Primary practice location

2020 E Grand Ave Ste 409
Laramie, WY 82070-4383

Mailing address

911 Sanders Dr
Laramie, WY 82070-4650
Phone (307) 399-0435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20220314001230 WY Practitioner - Clinical Social Worker 6406241298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2020 E Grand Ave
Suite 409
Laramie, WY 82070-4383
Phone (307) 399-0435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly Maffei LCSW, LLC Clinical CurrentSince Jan 1, 2022 Accepting new patients

Locations

2020 E Grand Ave
Ste 409
Laramie, WY 82070
Phone (307) 399-0435

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1841687233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 SANDERS DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820704650",
            "telephone_number": "307-399-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E GRAND AVE STE 409",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820704383",
            "telephone_number": "307-399-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAFFEI",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.