Individual provider Active NPI

Kimberly Kotrla, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1972943397
Registry record updated Jun 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1222 N Main Ave Ste 740-B
San Antonio, TX 78212-5712
Phone
(210) 271-7411
Fax
(210) 271-9414
NPI assigned
Jun 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X TX Primary

Addresses

Primary practice location

1222 N Main Ave Ste 740-B
San Antonio, TX 78212-5712

Mailing address

1222 N Main Ave Ste 740
San Antonio, TX 78212-5711
Phone (210) 271-7411

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

NPI Registry JSON

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

{
    "created_epoch": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372464000000",
    "number": "1972943397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 N MAIN AVE STE 740",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125711",
            "telephone_number": "210-271-7411",
            "fax_number": "210-271-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 N MAIN AVE STE 740-B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125712",
            "telephone_number": "210-271-7411",
            "fax_number": "210-271-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTRLA",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-29",
        "last_updated": "2013-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2013; 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.