Provider Demographics
NPI:1053558395
Name:BEVANS, KIMBERLY SCHMIDT (MA)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:SCHMIDT
Last Name:BEVANS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 NORTH AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-1747
Mailing Address - Country:US
Mailing Address - Phone:508-580-4691
Mailing Address - Fax:508-588-5751
Practice Address - Street 1:135 COLBURN ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2305
Practice Address - Country:US
Practice Address - Phone:617-651-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health