Provider Demographics
NPI:1215210885
Name:THRASHER, KIMBERLY RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RENEE
Last Name:THRASHER
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 1:1611 HAZEL DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6333
Mailing Address - Country:US
Mailing Address - Phone:540-303-0252
Mailing Address - Fax:540-302-8056
Practice Address - Street 1:1611 HAZEL DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6333
Practice Address - Country:US
Practice Address - Phone:540-303-0252
Practice Address - Fax:540-302-8056
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC163371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical