Kimberly A Waggoner in East Providence - Clinical
Kimberly A Waggoner - NPI 1114954302
Kimberly A Waggoner is a Clinical in East Providence, Rhode Island. Kimberly A Waggoner practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kimberly A Waggoner is 1114954302. The last update date is 2021-08-28.
Kimberly A Waggoner's current location address is 400 Massasoit Ave Ste 101, East Providence, Rhode Island. You can contact this provider via phone number 4016127693 and fax number 4014321509. The mailing address for Kimberly A Waggoner is 400 Massasoit Ave Ste 101, East Providence, Rhode Island. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kimberly A Waggoner |
|---|---|
| Address | 400 Massasoit Ave Ste 101, East Providence, Rhode Island |
| Phone Number | 4016127693 |
| Fax Number | 4014321509 |
| Sole Proprietor | Y |
| Credentials | MSW |
NPI Number Detail
| NPI Number | 1114954302 |
|---|---|
| Provider Enumeration Date | 2006-06-26 |
| Last Updated Date | 2021-08-28 |
Provider Mailing Address Detail
| Address | 400 Massasoit Ave Ste 101 |
|---|---|
| City | East Providence |
| State | Rhode Island (RI) |
| Post Code | 29142017 |
| Phone Number | 4016127693 |
| Fax Number | 4014321509 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | ISW00879 |
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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 |
|---|---|---|---|
| KW10798 | RI | -- | |
| 62-23076 | RI | UNITED BEHAVIORAL HEALTH | |
| 413014 | RI | BLUE CHIP | |
| 31025-9 | RI | BLUE CROSS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Kimberly A Waggoner by the Centers for Medicare & Medicaid Services?
The Kimberly A Waggoner has been issued the NPI (National Provider Identifier) 1114954302 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Kimberly A Waggoner's physical address?
The Kimberly A Waggoner is physically located at 400 Massasoit Ave Ste 101, in the city of East Providence, RI, with the postal code 29142017.
What is Kimberly A Waggoner's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kimberly A Waggoner is Clinical, and the corresponding taxonomy classification code for this specialized field is 1041C0700X.
On what date did the Kimberly A Waggoner receive the assignment of its 1114954302 from the Centers for Medicare & Medicaid Services?
The Kimberly A Waggoner was issued its 1114954302 by the Centers for Medicare & Medicaid Services on 2006-06-26.
When was the information regarding Kimberly A Waggoner, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Kimberly A Waggoner, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2021-08-28.