Kimberly Lauren Thornton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

218457 Issued in WI

Practice address

4855 S Moorland Rd Ste 250
New Berlin, WI 53151-7494

Phone

(262) 789-6020

Fax

(262) 789-6025

NPI assigned

Dec 16, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Kimberly Lauren Miller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kimberly.thornton.p1@direct.chcfhc.nextgenshare.com

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1861795684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 S MOORLAND RD STE 250",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517494",
            "telephone_number": "262-789-6020",
            "fax_number": "262-789-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1501309",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "218457",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "218457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1861795684",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MILLER",
            "middle_name": "LAUREN",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.