Provider Demographics
NPI:1437371903
Name:CENTORE, KIMBERLY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:CENTORE
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 1:138 NORTH COURT STREET
Mailing Address - Street 2:
Mailing Address - City:WAMPSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13163-0608
Mailing Address - Country:US
Mailing Address - Phone:315-366-2327
Mailing Address - Fax:
Practice Address - Street 1:138 NORTH COURT STREET
Practice Address - Street 2:
Practice Address - City:WAMPSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13163-0608
Practice Address - Country:US
Practice Address - Phone:315-366-2327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical