Active NPI
Kimberly Mae Kirklin, LCSW
- Clinical Social Worker
- Mexico, MO
National Provider Identifier
1861034381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2021029435
- Practice address
- 21998 Audrain Road 322
Mexico, MO 65265-5860 - Phone
- (660) 676-7599
- NPI assigned
- Oct 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2021029435 | MO | Primary |
| Social Worker | 104100000X | 2019015418 | MO |
Addresses
Primary practice location
21998 Audrain Road 322
Mexico, MO 65265-5860
Mailing address
21998 Audrain Road 322
Mexico, MO 65265-5860
Phone (660) 676-7599
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 |
|---|---|---|---|
| 2019015418 | MO | MD | Social Worker |
| 2021029435 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660521600000",
"number": "1861034381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21998 AUDRAIN ROAD 322",
"city": "MEXICO",
"state": "MO",
"postal_code": "652655860",
"telephone_number": "660-676-7599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21998 AUDRAIN ROAD 322",
"city": "MEXICO",
"state": "MO",
"postal_code": "652655860",
"telephone_number": "660-676-7599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKLIN",
"first_name": "KIMBERLY",
"middle_name": "MAE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-16",
"last_updated": "2022-08-15",
"certification_date": "2022-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2021029435",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2019015418",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mexico, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.