Provider Demographics
NPI:1083739791
Name:MORRIS, KIMBERLEY B (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:B
Last Name:MORRIS
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:PO BOX 2358
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2358
Mailing Address - Country:US
Mailing Address - Phone:910-279-6257
Mailing Address - Fax:252-726-4325
Practice Address - Street 1:3332 BRIDGES ST STE A
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3296
Practice Address - Country:US
Practice Address - Phone:252-726-9006
Practice Address - Fax:252-726-4325
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0029231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1156POtherBCBS
NC6003466Medicaid