Provider Demographics
NPI:1396967030
Name:KINSLER, KIMBERLY LYNNETTE (PSYD, LCSW)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:LYNNETTE
Last Name:KINSLER
Suffix:
Gender:F
Credentials:PSYD, LCSW
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 272374
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33688-2374
Mailing Address - Country:US
Mailing Address - Phone:813-690-4524
Mailing Address - Fax:813-264-9635
Practice Address - Street 1:3262 COVE BEND DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2752
Practice Address - Country:US
Practice Address - Phone:813-690-4524
Practice Address - Fax:813-264-9635
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW72531041C0700X
FLPY7565103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical