Provider Demographics
NPI:1053788620
Name:CLAIBORNE, KIMBERLY (LCPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:CLAIBORNE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 N ROLLING RD STE 305
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4142
Mailing Address - Country:US
Mailing Address - Phone:443-272-1097
Mailing Address - Fax:
Practice Address - Street 1:516 N ROLLING RD STE 305
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:443-272-1097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-30
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3164101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional