Longbottom, Kim K

Longbottom, Kim K is an individual health care provider with primary practice located at 3904 Oleander Dr Suite 101, Wilmington NC 28403-6717. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Longbottom, Kim K can be contacted via phone (910) 790-9500.

Contact Information

Primary practice address
3904 Oleander Dr Suite 101 Wilmington NC 28403-6717
Phone: (910) 790-9500
Fax: (910) 796-8111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1085 North Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X C0044309 North Carolina

Profile Details

NPI number 1417020173
LBN Legal business name Longbottom, Kim K
Credentials LCSW, LCAS
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2006
Last updated Jul 18th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417020173 NPPES
Other 1328P BCBS
Other 2132551 BCBS
MEDICAID 6002524 BCBS

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