| Kimberly Sauls Llc | |
|
1839 Cooper Rd Ste D Picayune MS 39466-2836 | |
| (601) 749-9477 | |
| (601) 749-0605 |
| Full Name | Kimberly Sauls Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1839 Cooper Rd Ste D, Picayune, Mississippi |
| Authorized Official Name and Position | Kimberly C Sauls (OWNER/PROVIDER) |
| Authorized Official Contact | 6017499477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Sauls Llc 1839 Cooper Rd Ste D Picayune MS 39466-2836 Ph: (601) 749-9477 | Kimberly Sauls Llc 1839 Cooper Rd Ste D Picayune MS 39466-2836 Ph: (601) 749-9477 |
| NPI Number | 1821584244 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 01/22/2020 |
| Certification Date | 01/22/2020 |
| Medicare PECOS PAC ID | 3577812791 |
|---|---|
| Medicare Enrollment ID | O20180822000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821584244 | NPI | - | NPPES |
| C4705 | Other | MS | MS BOARD OF EXAMINERS FOR SOCIAL WORKERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | C4705 (Mississippi) | Primary |
| Provider Name | Kimberly C Sauls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043232390 PECOS PAC ID: 3577588078 Enrollment ID: I20051013000659 |
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