Provider Demographics
NPI:1043391949
Name:KIMBERLY PLATT
Entity Type:Organization
Organization Name:KIMBERLY PLATT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PLATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LADC
Authorized Official - Phone:860-614-3555
Mailing Address - Street 1:805 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1670
Mailing Address - Country:US
Mailing Address - Phone:860-614-3555
Mailing Address - Fax:860-231-1515
Practice Address - Street 1:805 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1670
Practice Address - Country:US
Practice Address - Phone:860-614-3555
Practice Address - Fax:860-231-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004626101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty