Kim K Longbottom is a Clinical in Wilmington, North Carolina. Kim K Longbottom practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kim K Longbottom is 1417020173. The last update date is 2011-07-18.
Kim K Longbottom's current location address is 3904 Oleander Dr, Wilmington, North Carolina. You can contact this provider via phone number 9107909500 and fax number 9107968111. The mailing address for Kim K Longbottom is 3904 Oleander Dr, Wilmington, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kim K Longbottom |
|---|---|
| Address | 3904 Oleander Dr, Wilmington, North Carolina |
| Phone Number | 9107909500 |
| Fax Number | 9107968111 |
| Sole Proprietor | N |
| Credentials | LCSW, LCAS |
NPI Number Detail
| NPI Number | 1417020173 |
|---|---|
| Provider Enumeration Date | 2006-11-17 |
| Last Updated Date | 2011-07-18 |
Provider Mailing Address Detail
| Address | 3904 Oleander Dr |
|---|---|
| City | Wilmington |
| State | North Carolina (NC) |
| Post Code | 284036717 |
| Phone Number | 9107909500 |
| Fax Number | 9107968111 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | C0044309 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1328P | BCBS | ||
| 2132551 | NC | CIGNA | |
| 6002524 | NC | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Kim K Longbottom by the Centers for Medicare & Medicaid Services (CMS)?
The Kim K Longbottom has been assigned the NPI (National Provider Identifier) 1417020173. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Kim K Longbottom's facilities are situated?
The facilities of Kim K Longbottom are physically located at the following address: 3904 Oleander Dr, Wilmington, NC, 284036717.
What is the Kim K Longbottom's specialty and taxonomy code?
The Kim K Longbottom's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did the Kim K Longbottom receive its 1417020173 assignment from the Centers for Medicare & Medicaid Services?
The Kim K Longbottom was assigned its 1417020173 by the Centers for Medicare & Medicaid Services on 2006-11-17.
When was the Kim K Longbottom's information last updated?
The Kim K Longbottom's information was last updated on 2011-07-18.