Provider Demographics
NPI:1427448844
Name:FLYR, KIMBERLY S (MED, LCPC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:S
Last Name:FLYR
Suffix:
Gender:F
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13378 GRINSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-5614
Mailing Address - Country:US
Mailing Address - Phone:410-961-9284
Mailing Address - Fax:
Practice Address - Street 1:5026 DORSEY HALL DR STE 205
Practice Address - Street 2:MARTIN COUNSELING AND ASSOCIATES
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7854
Practice Address - Country:US
Practice Address - Phone:240-356-3528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-24
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4563101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional