Provider Demographics
NPI:1669070819
Name:KIMBERLY DOWD, LCSW, LLC
Entity type:Organization
Organization Name:KIMBERLY DOWD, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOWD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:918-344-3565
Mailing Address - Street 1:304 W WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-7022
Mailing Address - Country:US
Mailing Address - Phone:918-344-3565
Mailing Address - Fax:
Practice Address - Street 1:304 W WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-7022
Practice Address - Country:US
Practice Address - Phone:918-344-3565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1790894541OtherPERSONAL NPI