Provider Demographics
NPI:1124836168
Name:PIKOR, KIMBERLY LYNN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LYNN
Last Name:PIKOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:LYNN
Other - Last Name:DEVINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:48 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2511
Mailing Address - Country:US
Mailing Address - Phone:860-490-7486
Mailing Address - Fax:
Practice Address - Street 1:1216 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2672
Practice Address - Country:US
Practice Address - Phone:860-946-0447
Practice Address - Fax:860-781-8588
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6748104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker