Provider Demographics
NPI:1437822558
Name:DEBEER, KIMBERLY R (LICSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:DEBEER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 MERRIMAN DR
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:MN
Mailing Address - Zip Code:55328-9430
Mailing Address - Country:US
Mailing Address - Phone:612-227-3619
Mailing Address - Fax:
Practice Address - Street 1:6600 FRANCE AVE S STE 472
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1806
Practice Address - Country:US
Practice Address - Phone:612-227-3619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN272451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical