Provider Demographics
NPI:1376968339
Name:CASH, KIMBERLY (LISW-CP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:CASH
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GANTT ST STE 8
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2811
Mailing Address - Country:US
Mailing Address - Phone:803-586-3146
Mailing Address - Fax:
Practice Address - Street 1:1 GANTT ST STE 8
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2811
Practice Address - Country:US
Practice Address - Phone:803-586-3146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC72391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical