Provider Demographics
NPI:1699499004
Name:HAROLD-MAPLES, KIM
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HAROLD-MAPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 1/2 CHURCH ST S
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-1616
Mailing Address - Country:US
Mailing Address - Phone:910-528-1804
Mailing Address - Fax:
Practice Address - Street 1:504 1/2 CHURCH ST S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-1616
Practice Address - Country:US
Practice Address - Phone:910-528-1804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker