Provider Demographics
NPI:1346475852
Name:BRISCOE, KIMBERLY (LCMFT)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:BRISCOE
Suffix:
Gender:
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9199 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4520
Mailing Address - Country:US
Mailing Address - Phone:410-989-9922
Mailing Address - Fax:
Practice Address - Street 1:9199 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4520
Practice Address - Country:US
Practice Address - Phone:410-989-9922
Practice Address - Fax:410-989-9922
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM141106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD027729100Medicaid