CMS-1500 Box 24J / 33a • NPI
1659935427
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
104100000X
Licensed & Credentialed Social Worker
Box 32 Service Location & ZIP+4
110 MEDICAL CENTER DR, CLANTON, AL, 35045-2332
✓ 9-Digit EDI 837 ZIP+4 (35045-2332)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1659935427 (KIMBERLY E CLARK, LICSW) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1659935427 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KIMBERLY E CLARK, LICSW |
| Plain-English Specialty | Licensed & Credentialed Social Worker NUCC Code: 104100000X (Social Worker) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 110 MEDICAL CENTER DR, CLANTON, AL, 35045-2332 |
| Practice Telephone / Fax | Tel: (205) 651-0077 |
| Administrative Mailing Address | PO BOX 689, CALERA, AL, 35040-0689 |
| Enumeration & Last Sync | Enumerated: 2019-04-26 | CMS Record Updated: 2023-10-25 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (104100000X)
What Does Taxonomy Code 104100000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 104100000X translates to:
"Licensed & Credentialed Social Worker"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KIMBERLY E CLARK, LICSW)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101YM0800X — Counselor, Mental HealthPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: N/A | License: Verified | Primary: Secondary |
104100000X — Social WorkerPlain English: Licensed & Credentialed Social Worker | State: AL | License: 5455C | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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