Provider Demographics
NPI:1588940597
Name:HOWARD, KIMBERLY O (LISW-S)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:O
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 COUNTY ROAD 2000
Mailing Address - Street 2:
Mailing Address - City:JEROMESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44840-9757
Mailing Address - Country:US
Mailing Address - Phone:419-651-7840
Mailing Address - Fax:
Practice Address - Street 1:338 COUNTY ROAD 2000
Practice Address - Street 2:
Practice Address - City:JEROMESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44840-9757
Practice Address - Country:US
Practice Address - Phone:419-651-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 16002561041C0700X
OHI.1600256-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical