Reda Vernice Kirkwood, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3156-C Issued in AR

Practice address

407 Cleveland St
Forrest City, AR 72335-3302

Phone

(870) 945-5292

NPI assigned

Jul 31, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kingdom Connect Consulting Services, LLC

  • Mental Health Counselor
  • Marion, AR
  • NPI 1023756574
  NPD Authorized official

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1992229082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1354",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723361354",
            "telephone_number": "870-945-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 CLEVELAND ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723353302",
            "telephone_number": "870-945-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKWOOD",
        "first_name": "REDA",
        "middle_name": "VERNICE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "3156-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret J King, MHPP
• Santania King
• Sherra King, RN
• Amy Kinney, LMSW
• Pamela Lewis Kipkulei, OTD, OTR/L
• Stacy Knight, MHPP
• Sudhir Kumar, M.D.
• Laeartha Banks Counseling Services LLC
• Judith NM Lamarre
• Randy Larson, MHPP

• Clinical Social Worker in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.