Kimberly Averett
NPI 1508390667ActiveIndividual· Social Worker, Clinical· Tucker, GA
Social Worker, Clinical with The Southeast Permanente Medical Group, practicing in Tucker, Georgia. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1508390667 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 16, 2017 |
| Last updated in NPPES | Apr 16, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | CSW006057 | GA |
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 (GA) |
|---|
Education and affiliations
| Graduation year | 2011 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- The Southeast Permanente Medical GroupJonesboro, GA · 812 clinicians
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