Provider Demographics
NPI:1346475852
Name:BRISCOE ASANTE, KIMBERLY (LCMFT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:BRISCOE ASANTE
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 SEQUOIA AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7510
Mailing Address - Country:US
Mailing Address - Phone:410-578-1855
Mailing Address - Fax:
Practice Address - Street 1:1501 W SARATOGA ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-1749
Practice Address - Country:US
Practice Address - Phone:410-383-8300
Practice Address - Fax:410-383-3160
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD141106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD027729100Medicaid