Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim Shippey, LCSW

Individual provider Clinical Social Worker · NPI 1497817670

Kim Shippey, LCSW is a Clinical Social Worker in Santa Rosa, California. Qualified in 1991, 35 years ago. Accepts Medicare assignment. Licensed in California.

Years since qualifying
35
Licensed in
CA
In the registry since
2006
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

401 Bicentennial Way Adult Psychiatry
Santa Rosa, CA 95403-2149
Phone: (707) 571-4015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 17312 (CA)

Record details

NPI number1497817670
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 14, 2006
Last updated in NPPESJanuary 3, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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