Provider Demographics
NPI:1700935558
Name:GALE, KIMBERLY SUSAN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:SUSAN
Last Name:GALE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:SUSAN
Other - Last Name:MACMURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:43 DODGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4006
Mailing Address - Country:US
Mailing Address - Phone:508-699-4184
Mailing Address - Fax:508-643-0334
Practice Address - Street 1:218 PARK ST
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-1250
Practice Address - Country:US
Practice Address - Phone:508-643-1441
Practice Address - Fax:508-643-0334
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4975101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health