Provider Demographics
NPI:1497960827
Name:WARNER, KIMBERLEY TAYLER (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:TAYLER
Last Name:WARNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 W BEHREND DR APT 3107
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6960
Mailing Address - Country:US
Mailing Address - Phone:801-502-3459
Mailing Address - Fax:
Practice Address - Street 1:7055 W BELL RD STE 21
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8545
Practice Address - Country:US
Practice Address - Phone:623-878-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ121721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical