Provider Demographics
NPI:1598499329
Name:WATKINS, KIMBERLY ALTHEA (LMSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ALTHEA
Last Name:WATKINS
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 1:150 KIMBERTON CT UNIT A1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4277
Mailing Address - Country:US
Mailing Address - Phone:302-584-1205
Mailing Address - Fax:
Practice Address - Street 1:150 KIMBERTON CT UNIT A1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4277
Practice Address - Country:US
Practice Address - Phone:302-584-1205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0010941104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker