Provider Demographics
NPI:1528835170
Name:STANLEY, KIMBERLY (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 W OAKLAND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4214
Mailing Address - Country:US
Mailing Address - Phone:215-208-8085
Mailing Address - Fax:
Practice Address - Street 1:70 W OAKLAND AVE STE 201
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4214
Practice Address - Country:US
Practice Address - Phone:215-208-8085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016505101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional