Provider Demographics
NPI:1386708451
Name:EHRENSBECK, KIMBERLEY A (MS)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:A
Last Name:EHRENSBECK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:KIMBERLEY
Other - Middle Name:A
Other - Last Name:EHRENSBECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:800 BEARSES WAY 6SC
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-740-7304
Mailing Address - Fax:
Practice Address - Street 1:23 02 WHITES PATH
Practice Address - Street 2:SOUTH BAY MENTAL HEALTH CENTER
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664
Practice Address - Country:US
Practice Address - Phone:508-760-1475
Practice Address - Fax:508-760-3719
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health