Provider Demographics
NPI:1003005216
Name:WHORTON, KIMBERLEY J (LCSW, PIP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:J
Last Name:WHORTON
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 CHRISLYN DR
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-8318
Mailing Address - Country:US
Mailing Address - Phone:256-504-3887
Mailing Address - Fax:
Practice Address - Street 1:376 CHRISLYN DR
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-8318
Practice Address - Country:US
Practice Address - Phone:256-504-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL268-1020C1041C0700X
ALPIP268-1020C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical