Provider Demographics
NPI:1982288791
Name:URQUHART, KIMBERLY A (LICSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:URQUHART
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TAUNTON GRN STE 206
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3253
Mailing Address - Country:US
Mailing Address - Phone:508-974-4400
Mailing Address - Fax:
Practice Address - Street 1:12 TAUNTON GRN STE 206
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3253
Practice Address - Country:US
Practice Address - Phone:508-974-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-07
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2264691041C0700X
MA1273381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical