Provider Demographics
NPI:1437419181
Name:CLARKE, KIMBERLY MCCASKEY (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MCCASKEY
Last Name:CLARKE
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 1:1954 PIERCE BLUFFS DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-7346
Mailing Address - Country:US
Mailing Address - Phone:412-818-3864
Mailing Address - Fax:724-342-2303
Practice Address - Street 1:10 SNYDER RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3432
Practice Address - Country:US
Practice Address - Phone:412-818-3864
Practice Address - Fax:724-342-2303
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0152861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical