Provider Demographics
NPI:1912106444
Name:HUSENITS, KIMBERELY JUNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERELY
Middle Name:JUNE
Last Name:HUSENITS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 S CARPENTER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-2794
Mailing Address - Country:US
Mailing Address - Phone:724-357-7580
Mailing Address - Fax:
Practice Address - Street 1:31 S CARPENTER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-2794
Practice Address - Country:US
Practice Address - Phone:724-357-7580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-004769-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical