Provider Demographics
NPI:1104267798
Name:RINKO, KIMBERLY A (LCSW,MSW,BA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:RINKO
Suffix:
Gender:F
Credentials:LCSW,MSW,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1064
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06721-1064
Mailing Address - Country:US
Mailing Address - Phone:203-980-3850
Mailing Address - Fax:203-405-2238
Practice Address - Street 1:900 STRAITS TPKE
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2865
Practice Address - Country:US
Practice Address - Phone:203-598-4492
Practice Address - Fax:203-405-3328
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008049703Medicaid