Green, Kimberly D.

Green, Kimberly D. is an sole proprietor health care provider with primary practice located at 667 Spring Drive Ext , Winston Salem NC 27107-9788. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Green, Kimberly D. can be contacted via phone (253) 225-5418.

Contact Information

Primary practice address
667 Spring Drive Ext Winston Salem NC 27107-9788
Fax: (877) 410-5513
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LF00002194 Washington

Profile Details

NPI number 1275514077
LBN Legal business name Green, Kimberly D.
Credentials M.ED, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2005
Last updated Jul 7th, 2022 - about 4 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 1275514077 NPPES
Washington MEDICAID 1091299

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