CARMEN KADESHA JIMENEZ MSW LCSW LISW-CP NPI 1215280904

NPI Information

NPI: 1215280904
Provider Name: CARMEN KADESHA JIMENEZ, MSW, LCSW, LISW-CP
Classification: Social Worker - 1041C0700X
Specialization: Clinical
Entity Type: Individual
Address: 4460 WASHINGTON RD STE 19
EVANS, GA
ZIP 30809
Phone: (980) 275-2505

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NPI Details

Carmen Kadesha Jimenez, MSW, LCSW, LISW-CP is a clinical social worker in Evans, GA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Carmen Kadesha Jimenez, MSW, LCSW, LISW-CP NPI is 1215280904. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4460 WASHINGTON RD STE 19
EVANS, GA
ZIP 30809-963
Phone: (980) 275-2505
Fax: (207) 591-9801

The enumeration date for this NPI number is 10/18/2012 and was last updated on 2/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	P007687	NORTH CAROLINA	No
2	101YM0800X	Counselor	Mental Health	SW.10478 CP	SOUTH CAROLINA	No
3	1041C0700X	Social Worker	Clinical	P007687	NORTH CAROLINA	No
4	1041C0700X	Social Worker	Clinical	SW.10478 CP	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SW1128	MEDICAID	SOUTH CAROLINA
2	003213277A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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