Provider Demographics
NPI:1518357367
Name:HARE, KIMBERLY ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:HARE
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 1:2000 HOLLYWOOD DR
Mailing Address - Street 2:JFS
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4210
Mailing Address - Country:US
Mailing Address - Phone:717-843-5011
Mailing Address - Fax:717-846-3025
Practice Address - Street 1:2000 HOLLYWOOD DR
Practice Address - Street 2:JFS
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4210
Practice Address - Country:US
Practice Address - Phone:717-843-5011
Practice Address - Fax:717-846-3025
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0178741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical