Provider Demographics
NPI:1063828978
Name:GERMAN, KIM (LSCSW)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:GERMAN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8221 SIENNA SKIES CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-5259
Mailing Address - Country:US
Mailing Address - Phone:316-347-9419
Mailing Address - Fax:
Practice Address - Street 1:8221 SIENNA SKIES CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-5259
Practice Address - Country:US
Practice Address - Phone:316-347-9419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS47671041C0700X
NV9702-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201098650CMedicaid