Provider Demographics
NPI:1437813235
Name:KIMBERLY GARRISON, LCSW-C, LLC
Entity Type:Organization
Organization Name:KIMBERLY GARRISON, LCSW-C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-466-9195
Mailing Address - Street 1:2923 OLNEY SANDY SPRING RD STE B
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1581
Mailing Address - Country:US
Mailing Address - Phone:301-466-9195
Mailing Address - Fax:
Practice Address - Street 1:2923 OLNEY SANDY SPRING RD STE B
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1581
Practice Address - Country:US
Practice Address - Phone:301-466-9195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health