Provider Demographics
NPI:1013017904
Name:DENSON, KIMBERLY BURNHAM (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:BURNHAM
Last Name:DENSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 HIGHWAY 51 STE F2
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-3424
Mailing Address - Country:US
Mailing Address - Phone:601-790-9266
Mailing Address - Fax:601-790-9267
Practice Address - Street 1:299 HIGHWAY 51 STE F2
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-3424
Practice Address - Country:US
Practice Address - Phone:601-790-9266
Practice Address - Fax:601-790-9267
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC64811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical