Provider Demographics
NPI:1073208385
Name:KIMBRELL, CASEY STEPP (LMSW, ADC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:STEPP
Last Name:KIMBRELL
Suffix:
Gender:F
Credentials:LMSW, ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 HUMAN SERVICES RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-7548
Mailing Address - Country:US
Mailing Address - Phone:864-833-6500
Mailing Address - Fax:
Practice Address - Street 1:219 HUMAN SERVICES RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7548
Practice Address - Country:US
Practice Address - Phone:864-833-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15208104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker