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KIMBERLY A WAGGONER MSW
NPI 1114954302
Social Worker - Clinical in East Providence, RI

Active since June 26, 2006PECOS Enrolled
400 MASSASOIT AVE STE 101, EAST PROVIDENCE, RI 02914(401) 612-7693(401) 432-1500 Get Directions Write a Review

NPPES record last updated: August 28, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kimberly A Waggoner Msw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY A WAGGONER MSW (NPI 1114954302) is an individual clinical provider in East Providence, Rhode Island, licensed in Rhode Island (ISW00879) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114954302
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKIMBERLY A WAGGONERCredential: MSW
Location Address400 MASSASOIT AVE STE 101East Providence, RI 02914-2017
Mailing Address400 Massasoit Ave Ste 101East Providence, RI 02914-2017 · (401) 612-7693 · Fax (401) 432-1509
Phone(401) 612-7693
Fax(401) 432-1500
Sole ProprietorYes
Enumeration DateJune 26, 2006
Last NPPES UpdateAugust 28, 2021
NPPES CertifiedAugust 28, 2021
✔ NPI 1114954302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in RI · ISW00879
Definition
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.
400 MASSASOIT AVE STE 101, East Providence, RI 02914
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Other Identifiers 4

Other62-23076RI · United Behavioral Health
Other413014RI · Blue Chip
MedicaidKW10798RI
Other31025-9RI · Blue Cross

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly A Waggoner Msw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02914 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $58.57 – $177.03
Typical copayment $0.00 (range $14.64 – $44.25)
Most-billed visit code NA
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLINE GOJCZ LICSW LLC
Social Worker (Clinical)
400 MASSASOIT AVE STE 101
EAST PROVIDENCE, RI 02914
Providence County (401) 250-0079
CAROLINE IACONO GOJCZ LICSW
Counselor (Mental Health)
400 MASSASOIT AVE STE 101
EAST PROVIDENCE, RI 02914
Providence County (401) 250-0079

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Waggoner's NPI number?

The NPI number for Kimberly Waggoner is 1114954302. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Where is Kimberly Waggoner located?

Kimberly Waggoner practices at 400 Massasoit Ave Ste 101, East Providence, RI 02914. The listed phone number is (401) 612-7693.

What is Kimberly Waggoner's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kimberly Waggoner enrolled in Medicare?

Yes. Kimberly Waggoner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Waggoner was last updated on August 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.