Provider Demographics
NPI:1760802623
Name:ADAMS, KIMBERLY MARSHALL (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MARSHALL
Last Name:ADAMS
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 1:1047 TREELINE DR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6009
Mailing Address - Country:US
Mailing Address - Phone:484-560-2080
Mailing Address - Fax:610-861-4677
Practice Address - Street 1:35 E ELIZABETH AVE STE 26
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6505
Practice Address - Country:US
Practice Address - Phone:610-739-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
PACW0204651041C0700X
PASW128220104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker