Kim Clarissa Dallas, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06207700 Issued in NJ

Practice address

239 Golden Hill LN
Kingston, NY 12401-6441

Phone

(845) 340-4135

Fax

(845) 340-4094

NPI assigned

Aug 16, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kim Clarissa Weeks Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stationmd Professional CorporationGroup PAC ID 6204184104, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stationmd Professional Corporation

  • Emergency Medicine Physician
  • Maplewood, NJ
  • NPI 1285015347
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328

  Clinical

  Medicare reassignment NPD
• Live Life Now Health Group of NJ PC

  • Addiction Medicine (Family Medicine) Physician
  • Mount Laurel, NJ
  • NPI 1215566393
  Medicare reassignment NPD
• Regional Women'S Health Group, LLC

  • Obstetrics & Gynecology Physician
  • Voorhees, NJ
  • NPI 1548215536

  Social Worker

  Medicare reassignment NPD
• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448
  NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical

  NPD
• Regional Womens Health Group LLC

  • Obstetrics & Gynecology Physician
  • Phoenixville, PA
  • NPI 1750880118

  Social Worker

  NPD

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1851383889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 GOLDEN HILL LN",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016441",
            "telephone_number": "845-340-4125",
            "fax_number": "845-340-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 GOLDEN HILL LN",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016441",
            "telephone_number": "845-340-4135",
            "fax_number": "845-340-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "KIM",
        "middle_name": "CLARISSA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06207700",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "WEEKS",
            "middle_name": "CLARISSA",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Marie D'Andrea, MD
• Melissa Maria Dagele, COTA
• Judith M Dagirmanjian, CSW-R
• Steve Dagirmanjian, PHD
• Tracy-Ann Daley
• Noelle Ghnassia Damon, LCSW
• Daniel Hafner Physician PC
• Christopher Kelley Daniels
• Fabio O Danisi, M.D.
• Logan Gray Darkholme

• Clinical Social Worker in Kingston, NY
• Providers in Kingston, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.