Provider Demographics
NPI:1154071629
Name:KIMBALL WHITE, HILLARY A (MSWCC)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:A
Last Name:KIMBALL WHITE
Suffix:
Gender:F
Credentials:MSWCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LEAVITT ST
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-1843
Mailing Address - Country:US
Mailing Address - Phone:207-399-5589
Mailing Address - Fax:
Practice Address - Street 1:30 LEAVITT ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1843
Practice Address - Country:US
Practice Address - Phone:207-399-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-26
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC211091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical