1265829410 NPI number — MRS. KIMBERLY AD KAPINOS LCSW

Table of content: MRS. KIMBERLY AD KAPINOS LCSW (NPI 1265829410)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265829410 NPI number — MRS. KIMBERLY AD KAPINOS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAPINOS
Provider First Name:
KIMBERLY
Provider Middle Name:
AD
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAVIS
Provider Other First Name:
KIMBERLY
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265829410
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 COLUMBUS AVE
Provider Second Line Business Mailing Address:
CREDENTIALING SPECIALIST
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06519-1233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-503-3174
Provider Business Mailing Address Fax Number:
203-503-3183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 COLUMBUS AVE
Provider Second Line Business Practice Location Address:
CFG-COLUMBUS
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06519-1233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-503-3055
Provider Business Practice Location Address Fax Number:
203-503-3066
Provider Enumeration Date:
04/24/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  9950 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004235918 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com