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General NPI Number Information
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NPI Number | 1043391949
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Entity Type | Organization
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Legal Business Name | KIMBERLY PLATT
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 805 FARMINGTON AVE
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1670
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Country | US
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Telephone | 860-614-3555
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Fax | 860-231-1515
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Provider Business Mailing Address
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Address Line | 805 FARMINGTON AVE
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1670
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Country | US
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Telephone | 860-614-3555
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Fax | 860-231-1515
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Authorized Official
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Title or Position | COUNSELOR
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Name | MS. KIMBERLY D. PLATT
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Credential | LCSW LADC
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Telephone | 860-614-3555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 004626
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License Number State | CT
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