Provider Demographics
NPI:1164823795
Name:LARKINS, KIM T (LCSW)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:T
Last Name:LARKINS
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 1:7 COURT ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1709
Mailing Address - Country:US
Mailing Address - Phone:207-694-2230
Mailing Address - Fax:888-635-4735
Practice Address - Street 1:7 COURT ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1709
Practice Address - Country:US
Practice Address - Phone:207-694-2230
Practice Address - Fax:888-635-4735
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MELC171831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1164823795Medicaid