Provider Demographics
NPI:1053196543
Name:CLYMER, KRISTEN (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CLYMER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4304
Mailing Address - Country:US
Mailing Address - Phone:386-236-3215
Mailing Address - Fax:
Practice Address - Street 1:330 KAY LARKIN DR
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-2307
Practice Address - Country:US
Practice Address - Phone:434-229-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW21980104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker