| Cynthia L Kimball, Lmsw, Acsw, Achp-sw, Plc | |
|
640 3 Mile Rd Nw Suite 101 Grand Rapids MI 49544-8209 | |
| (616) 785-8900 | |
| (616) 785-8949 |
| Full Name | Cynthia L Kimball, Lmsw, Acsw, Achp-sw, Plc |
|---|---|
| Speciality | Social Worker |
| Location | 640 3 Mile Rd Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Cynthia Lousie Kimball (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6167858900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cynthia L Kimball, Lmsw, Acsw, Achp-sw, Plc 640 3 Mile Rd Nw Suite 101 Grand Rapids MI 49544-8209 Ph: (616) 785-8900 | Cynthia L Kimball, Lmsw, Acsw, Achp-sw, Plc 640 3 Mile Rd Nw Suite 101 Grand Rapids MI 49544-8209 Ph: (616) 785-8900 |
| NPI Number | 1295072320 |
|---|---|
| Provider Enumeration Date | 01/09/2013 |
| Last Update Date | 01/09/2013 |
| Medicare PECOS PAC ID | 1759536683 |
|---|---|
| Medicare Enrollment ID | O20130227000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295072320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cynthia L Kimball |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699010298 PECOS PAC ID: 7012162944 Enrollment ID: I20130227000013 |
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