Provider Demographics
NPI:1851527196
Name:FRANCIS, KIMBERLY SCOTT (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:SCOTT
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:450 HERITAGE RD
Mailing Address - Street 2:STE 3E
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-3878
Mailing Address - Country:US
Mailing Address - Phone:860-946-3758
Mailing Address - Fax:203-586-1600
Practice Address - Street 1:450 HERITAGE RD
Practice Address - Street 2:STE 3E
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-3878
Practice Address - Country:US
Practice Address - Phone:860-946-3758
Practice Address - Fax:203-586-1600
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CT88811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor