Healthcare Provider Details

I. General information

NPI: 1467369975
Provider Name (Legal Business Name): KIMBERLY CHAMBERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1638
MASHPEE MA
02649-1638
US

IV. Provider business mailing address

38 PARKER RD
PEMBROKE MA
02359-3051
US

V. Phone/Fax

Practice location:
  • Phone: 781-336-9975
  • Fax:
Mailing address:
  • Phone: 781-336-9975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: