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NPI Code Detail

MEDICARE: KIMBERLY ANNE KOENIG LCSWA

MEDICARE: KIMBERLY ANNE KOENIG LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator5815KY
21041C0700XClinical Social WorkerP007889NC

General Provider Information

NPI Number : 1316296304
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ANNE KOENIG LCSWA
Provider Business Mailing Address
First Line : 2875 WORTH DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-6248
Country : US
Telephone Number : 910-392-4881
Fax Number :
Provider Business Practice Location Address
First Line : 2875 WORTH DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-6248
Country : US
Telephone Number : 910-392-4881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2012
Last Update Date : 08/12/2013

Similar Medicare Providers

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Practice Location Address:
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Directions to “ KIMBERLY ANNE KOENIG LCSWA” Practice Location

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