Provider Demographics
NPI:1346735891
Name:PIERRE, KINSEY BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KINSEY
Middle Name:BETH
Last Name:PIERRE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N MCCARTHY RD STE P
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-9112
Mailing Address - Country:US
Mailing Address - Phone:920-903-1060
Mailing Address - Fax:920-903-1164
Practice Address - Street 1:119 N MCCARTHY RD STE P
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-9112
Practice Address - Country:US
Practice Address - Phone:920-903-1060
Practice Address - Fax:920-903-1164
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131062-1211041C0700X
WI9426-1231041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program