Kimberly Marie Black, LCSW
NPI 1215528955ActiveIndividual· Social Worker, Clinical· Farmington, MO
Social Worker, Clinical (LCSW) in Farmington, Missouri, licensed in MO, with an NPI issued in January 2021. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1215528955 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | Yes |
| NPI issued | Jan 26, 2021 |
| Last updated in NPPES | May 4, 2023 |
| Certified by provider | May 4, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 2019005809 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MO) |
|---|
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