Provider Demographics
NPI:1851684070
Name:VENSEL, KIMBERLY BETH (LSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BETH
Last Name:VENSEL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 YORK RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-9253
Mailing Address - Country:US
Mailing Address - Phone:717-249-7969
Mailing Address - Fax:
Practice Address - Street 1:1201 W ELM AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-4600
Practice Address - Country:US
Practice Address - Phone:717-632-8400
Practice Address - Fax:717-632-9300
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW005243E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker