Provider Demographics
NPI:1700513678
Name:YARBRO, KIMBERLY M (LMSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:YARBRO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:901-478-0966
Mailing Address - Fax:901-478-0951
Practice Address - Street 1:76 CAPITAL WAY STE C
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-6866
Practice Address - Country:US
Practice Address - Phone:901-840-1202
Practice Address - Fax:901-840-1204
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN105240104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker