Provider Demographics
NPI:1952731127
Name:KAZSIMER, KELLY KATHLEEN (MSCP, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:KATHLEEN
Last Name:KAZSIMER
Suffix:
Gender:F
Credentials:MSCP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NORTH POINTE CIRCLE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046
Mailing Address - Country:US
Mailing Address - Phone:724-772-4848
Mailing Address - Fax:
Practice Address - Street 1:3402 WASHINGTON RD
Practice Address - Street 2:SUITE 304
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2964
Practice Address - Country:US
Practice Address - Phone:724-941-5363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007214101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional