Healthcare Provider Details

I. General information

NPI: 1073522934
Provider Name (Legal Business Name): KIMBERLEE MARIE CULVER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5060 RTE 30 SUITE 2
SCHOHARIE NY
12157
US

IV. Provider business mailing address

PO BOX 664
SCHOHARIE NY
12157-0664
US

V. Phone/Fax

Practice location:
  • Phone: 518-295-8090
  • Fax:
Mailing address:
  • Phone: 518-295-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number043046
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: