Provider Demographics
NPI:1427287705
Name:COLEMAN PRIER, KIMBERLY SUSAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SUSAN
Last Name:COLEMAN PRIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5052 BALSAM DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-5627
Mailing Address - Country:US
Mailing Address - Phone:813-957-7348
Mailing Address - Fax:850-267-0034
Practice Address - Street 1:5052 BALSAM DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-5627
Practice Address - Country:US
Practice Address - Phone:813-957-7348
Practice Address - Fax:850-267-0034
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 76611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7670095 00Medicaid