Provider Demographics
NPI:1568613008
Name:PULLEY, KIMBERLY CATHCART (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CATHCART
Last Name:PULLEY
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 1:7350 BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3512
Mailing Address - Country:US
Mailing Address - Phone:804-559-0564
Mailing Address - Fax:
Practice Address - Street 1:5700 OLD RICHMOND AVE
Practice Address - Street 2:STE G30
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1828
Practice Address - Country:US
Practice Address - Phone:804-745-2225
Practice Address - Fax:804-745-2242
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040037981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical