MEDICARE: KIMBERLY HAYES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	1041C0700X	Clinical Social Worker	MD
2	171M00000X	Case Manager/Care Coordinator
3	1041C0700X	Clinical Social Worker	DC

General Provider Information

NPI Number	:	1619778438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY HAYES

Provider Business Mailing Address
First Line	:	6202 WALNUT ST
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-6522
Country	:	US
Telephone Number	:	202-848-3638
Fax Number	:

Provider Business Practice Location Address
First Line	:	6202 WALNUT ST
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-6522
Country	:	US
Telephone Number	:	202-848-3638
Fax Number	:	202-848-3638

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	02/18/2026

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