Provider Demographics
NPI:1710323779
Name:PIPES, KIMBERLY VARGAS (LCSW-A)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:VARGAS
Last Name:PIPES
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-4209
Mailing Address - Country:US
Mailing Address - Phone:865-978-8989
Mailing Address - Fax:
Practice Address - Street 1:6646 E WT HARRIS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-5140
Practice Address - Country:US
Practice Address - Phone:704-567-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0079751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical