Provider Demographics
NPI:1053719070
Name:STENSON, KIMBERLY ANN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:STENSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:CRABTREE
Mailing Address - State:PA
Mailing Address - Zip Code:15624-0404
Mailing Address - Country:US
Mailing Address - Phone:724-454-9117
Mailing Address - Fax:724-668-8837
Practice Address - Street 1:2573 ROUTE 119
Practice Address - Street 2:
Practice Address - City:CRABTREE
Practice Address - State:PA
Practice Address - Zip Code:15624-1001
Practice Address - Country:US
Practice Address - Phone:724-454-9117
Practice Address - Fax:724-668-8837
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000805106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist