Provider Demographics
NPI:1225254527
Name:KIMBER, STEPHANIE BERNIUS (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:BERNIUS
Last Name:KIMBER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:BERNIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:19 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3632
Mailing Address - Country:US
Mailing Address - Phone:603-355-2244
Mailing Address - Fax:603-355-2299
Practice Address - Street 1:19 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3632
Practice Address - Country:US
Practice Address - Phone:603-355-2244
Practice Address - Fax:603-355-2299
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH692101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2248064OtherCIGNA PROVIDER NUMBER
NH2473-05OtherHARVARD PILGRIM PROV. #
NH14Y008732NH01OtherANTHEM BHN PROVIDER NUMBE
NH30423733Medicaid