Provider Demographics
NPI:1679607642
Name:ATWOOD, KIMBERLY (MA, LPC, MT-BC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:MA, LPC, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N BROAD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3755
Mailing Address - Country:US
Mailing Address - Phone:215-767-1224
Mailing Address - Fax:
Practice Address - Street 1:107 N BROAD ST STE 300
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-3755
Practice Address - Country:US
Practice Address - Phone:215-767-1224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000983225A00000X
PA005998101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist