Provider Demographics
NPI:1518326735
Name:MORRISON, KIMBERLY ANN (LCSW LC17144)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LCSW LC17144
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 N BELFAST AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-0206
Mailing Address - Country:US
Mailing Address - Phone:207-200-5840
Mailing Address - Fax:207-333-3037
Practice Address - Street 1:2821 N BELFAST AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-0206
Practice Address - Country:US
Practice Address - Phone:207-200-5840
Practice Address - Fax:855-508-6515
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC158771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME15877Medicaid
MEMC15877Medicaid