Provider Demographics
NPI:1992117998
Name:MORGAN, KIMBERLY MAURINE (CSW-PIP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:MAURINE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-5745
Mailing Address - Country:US
Mailing Address - Phone:605-328-2999
Mailing Address - Fax:
Practice Address - Street 1:600 N SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-5745
Practice Address - Country:US
Practice Address - Phone:605-328-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-24
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD32771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical