Kimberley J Paul, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C8551 Issued in MS

Practice address

1700 W Government St Ste 201
Brandon, MS 39042

Phone

(601) 934-1021

NPI assigned

May 13, 2008

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rankin Baptist Association

  • Counselor
  • Pearl, MS
  • NPI 1114962560
  NPD (past)

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1912174673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WOODGATE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422176",
            "telephone_number": "601-934-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W GOVERNMENT ST STE 201",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39042",
            "telephone_number": "601-934-1021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7810 Ballantyne Commons Pkwy",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773415",
            "country_code": "US",
            "telephone_number": "704-400-3831",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Ballantyne Commons Pkwy",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773415",
            "country_code": "US",
            "telephone_number": "704-400-3831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUL",
        "first_name": "KIMBERLEY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005515",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kpaullcsw@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1700 W Government St Ste 201",
            "city": "Brandon",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390422423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Austin Blake Patrick, DPT
• Lexxus Patrick
• Allison Patterson, FNP
• Ann D Patterson, MD
• Mike V. Patti, LPC
• Constance Wheatley Payne, PHARMD
• PB Mississippi Health Services, LLC
• Lauren Callie Peace
• Peak Therapy LLC
• Pendleton Counseling Center

• Clinical Social Worker in Brandon, MS
• Providers in Brandon, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.