Provider Demographics
NPI:1184019499
Name:WINSOR, KIMBERLY CLARK (LCSW, LSCSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:CLARK
Last Name:WINSOR
Suffix:
Gender:F
Credentials:LCSW, LSCSW
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:CLARK
Other - Last Name:WINSOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, LSCSW
Mailing Address - Street 1:12975 S HAGAN ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-8861
Mailing Address - Country:US
Mailing Address - Phone:913-390-3356
Mailing Address - Fax:
Practice Address - Street 1:620 E 18TH ST STE 203
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1513
Practice Address - Country:US
Practice Address - Phone:816-366-5515
Practice Address - Fax:816-819-5873
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180068561041C0700X
TX108531041C0700X
KS058411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical