Kimberly Hartshorn Marley, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C011929 Issued in NC

Practice address

5613 Duraleigh Rd Ste 161
Raleigh, NC 27612-2709

Phone

(919) 784-0205

Fax

(919) 784-0250

NPI assigned

Mar 23, 2019

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 Marley Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553299200000",
    "number": "1922568005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914D ATHENS DR UNIT D",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276061524",
            "telephone_number": "919-961-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5613 DURALEIGH RD STE 161",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122709",
            "telephone_number": "919-784-0205",
            "fax_number": "919-784-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLEY",
        "first_name": "KIMBERLY",
        "middle_name": "HARTSHORN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-23",
        "last_updated": "2019-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C011929",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "MARLEY",
            "credential": "MSW, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John J Marks, MD
• Phillip Glenn Marks, M.D.
• Whitney Dale Marks, FNP
• Elizabeth Marlatt
• Jalea Lashae Marley, LCSW-A
• Marlo Watson
• Mary Grace Marlow, LCSW
• Kimberly G. Marmol
• Trina Marie Marone, P.T.
• John Robert Maroney

• All providers in Raleigh, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.