Provider Demographics
NPI:1366472888
Name:WHITMOYER, KIMBERLY C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:C
Last Name:WHITMOYER
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 1:4335 TUCKER NORTH CT
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-3625
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:404-417-1616
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:ATLANTA VAMC/ 11B
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-417-1616
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW30531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical