| Kimberly Carpenter Herring, L.l.c. | |
|
871 Sw State Road 47 Lake City FL 32025-0433 | |
| (386) 961-9616 | |
| (386) 754-1325 |
| Full Name | Kimberly Carpenter Herring, L.l.c. |
|---|---|
| Speciality | Social Worker |
| Location | 871 Sw State Road 47, Lake City, Florida |
| Authorized Official Name and Position | Kim Carpenter Herring (OWNER) |
| Authorized Official Contact | 3863970696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Carpenter Herring, L.l.c. 871 Sw State Road 47 Lake City FL 32025-0433 Ph: (386) 961-9616 | Kimberly Carpenter Herring, L.l.c. 871 Sw State Road 47 Lake City FL 32025-0433 Ph: (386) 961-9616 |
| NPI Number | 1598154668 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 03/11/2024 |
| Certification Date | 03/11/2024 |
| Medicare PECOS PAC ID | 4587925078 |
|---|---|
| Medicare Enrollment ID | O20180226000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598154668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW 5491 (Florida) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Kimberly C Herring |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508170838 PECOS PAC ID: 2961479951 Enrollment ID: I20040910000144 |
| Provider Name | Ashley B Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649789645 PECOS PAC ID: 2466862644 Enrollment ID: I20201028002533 |
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