Healthcare Provider Details

I. General information

NPI: 1821962473
Provider Name (Legal Business Name): TO-SHERA FRIEND-KIMBLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7229 FOREST AVE STE 111
RICHMOND VA
23226-3765
US

IV. Provider business mailing address

PO BOX 40412
BELFAST ME
04915-1255
US

V. Phone/Fax

Practice location:
  • Phone: 804-687-4793
  • Fax: 855-618-2628
Mailing address:
  • Phone: 804-687-4793
  • Fax: 855-618-2628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904012647
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: