Provider Demographics
NPI:1568651172
Name:THWING, KIMBERLY DIANE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:DIANE
Last Name:THWING
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 1:2411 BRIAR CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1396
Mailing Address - Country:US
Mailing Address - Phone:810-744-2246
Mailing Address - Fax:
Practice Address - Street 1:2411 BRIAR CREEK LN
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1396
Practice Address - Country:US
Practice Address - Phone:810-744-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801046574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health