NPIMap

Organization Active NPI

Kimberly a. Kick, LCSW & Associates, LTD.

Doing business as Libertyville Insight & Behavioral Center

  • Community/Behavioral Health Agency
  • Libertyville, IL
National Provider Identifier
1871938753
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
060011046 Issued in IL
Legal business name
KIMBERLY A. KICK, LCSW & ASSOCIATES, LTD.
Doing business as
Libertyville Insight & Behavioral Center
Practice address
709 N Milwaukee Ave
Libertyville, IL 60048-1913
Phone
(847) 400-6204
Fax
(847) 327-1592
NPI assigned
May 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Authorized official

Name
Dr. Kimberly A Kick, PHD,MSW, LCSWNPI 1528114824
Title
Owner
Phone
(847) 400-6204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 149-005107 IL
Community/Behavioral Health Agency 251S00000X 060011046 IL Primary

Addresses

Primary practice location

709 N Milwaukee Ave
Libertyville, IL 60048-1913

Mailing address

709 N Milwaukee Ave
Libertyville, IL 60048-1913
Phone (847) 400-6204

Other identifiers 1

IdentifierTypeStateIssuer
IL1548OtherILPTAN

Other names 1

  • Libertyville Insight & Behavioral Center Doing business as

National Provider Directory

National Provider Directory

Locations

709 N Milwaukee Ave
Libertyville, IL 60048
Phone (847) 400-6204

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1871938753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481913",
            "telephone_number": "847-400-6204",
            "fax_number": "847-327-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481913",
            "telephone_number": "847-400-6204",
            "fax_number": "847-327-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY A. KICK, LCSW & ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "KICK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-400-6204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD,MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149-005107",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "060011046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL1548",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Libertyville Insight & Behavioral Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.