MS. KIM K LONGBOTTOM (NPI# 1417020173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417020173 |
| Entity Type | Individual |
| Full Name | MS. KIM K LONGBOTTOM |
| Credential | LCSW, LCAS |
| Practice Address |
3904 Oleander Dr Suite 101 Wilmington NC 28403-6717 |
| Practice Telephone | 9107909500 |
| Practice Fax Number | 9107968111 |
| Mailing Telephone | 9107909500 |
| Mailing Fax Number | 9107968111 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2011-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1085 | NC | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C0044309 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 1328P | 01 | |
| NC | 6002524 | 05 | |
| NC | CIGNA | 2132551 | 01 |
| Street Address |
3904 OLEANDER DR SUITE 101 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-6717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346273091 | Behavioral Healthcare Services, Inc. | Behavioral Analyst | 3904 Oleander Dr, Wilmington, NC 28403-6717 | 2006-07-08 |
| 1487131298 | Desiree Macdonald | Behavior Technician | 3904 Oleander Dr, Suite 102, Wilmington, NC 28403-6735 | 2018-07-24 |
| 1922530278 | Karina Ordonez | Behavior Technician | 3904 Oleander Dr, Suite 102, Wilmington, NC 28403-6717 | 2017-03-28 |
| 1376084087 | Liana Mino | Behavior Technician | 3904 Oleander Dr, #102, Wilmington, NC 28403-6717 | 2017-03-14 |
| 1952848947 | Sydney Pickard | Behavior Technician | 3904 Oleander Dr, #102, Wilmington, NC 28403-6717 | 2017-01-27 |
| 1659818979 | Elizabeth Wannstedt | Behavior Technician | 3904 Oleander Dr, Suite 102, Wilmington, NC 28403-6717 | 2017-01-24 |
| 1881130052 | Crystal O'mara | Assistant Behavior Analyst | 3904 Oleander Dr, Wilmington, NC 28403-6717 | 2017-01-12 |
| 1285176958 | Lyrica Leigh Squires | Behavior Technician | 3904 Oleander Dr, Suite 102, Wilmington, NC 28403-6717 | 2016-11-13 |
| 1720440167 | Heather Overton | Psychologist | 3904 Oleander Dr, Wilmington, NC 28403-6717 | 2016-03-24 |
| 1952719510 | Rebecca Daniel | Psychologist | 3904 Oleander Dr, Suite 101, Wilmington, NC 28403-6717 | 2014-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602608 | Bhs Counseling, Pllc | Social Worker | 446 Motts Creek Rd, Wilmington, NC 28412-7854 | 2020-08-31 |
| 1659985406 | Kelsey Metz | Social Worker | 2023 S 17th St Unit 1a, Wilmington, NC 28401-6600 | 2020-08-31 |
| 1265044424 | Katelyn Elizabeth Currie | Social Worker | 3401 Wilshire Blvd Apt 103, Wilmington, NC 28403-4261 | 2020-08-19 |
| 1114539467 | Personal Insight Therapy, LLC | Social Worker | 226 Lowell St Ste B7, Wilmington, MA 01887-3073 | 2020-08-18 |
| 1336751726 | Ikia Williams | Social Worker | 4415 Junction Park Dr, Wilmington, NC 28412-2263 | 2020-08-18 |
| 1356961627 | Jacqueline Sabella | Social Worker | 1608 Queen St, Wilmington, NC 28401-5527 | 2020-04-16 |
| 1649808528 | Jessie Therese Redden | Social Worker | 5235 W Woodmill Dr Ste 47, Wilmington, DE 19808-4068 | 2020-03-27 |
| 1659907830 | Danielle M Lopez | Social Worker | 2700 Silverside Rd Ste 4, Wilmington, DE 19810-3724 | 2020-03-19 |
| 1942836267 | Christiana Care Health Initiatives | Social Worker | 4000 Nexus Dr Rm Nwg -250, Wilmington, DE 19803-3000 | 2020-03-18 |
| 1952936049 | Taylor Danielle Quick-smith | Social Worker | 1002 Talcon Dr, Wilmington, DE 19804-1200 | 2020-03-09 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.