Provider Demographics
NPI:1003117011
Name:KUENY, KIMBERLY G (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:G
Last Name:KUENY
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 1:900 DIXIE TRAIL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6840
Mailing Address - Country:US
Mailing Address - Phone:919-413-5992
Mailing Address - Fax:919-872-1170
Practice Address - Street 1:1001 NAVAHO DR
Practice Address - Street 2:SUITE 210
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7335
Practice Address - Country:US
Practice Address - Phone:919-872-1178
Practice Address - Fax:919-872-1170
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-07
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0074771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical