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General NPI Number Information
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NPI Number | 1093785339
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Entity Type | Individual
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Provider Name | KATHLEEN KLEMER GUMIENNY LCSW C
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Gender | Female
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 480 PIERCE ST #305
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City | KINGSTON
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State | PA
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Zip | 18704-5512
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Country | US
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Telephone | 410-991-2077
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Fax | 570-696-1526
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Provider Business Mailing Address
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Address Line | 2031 RUDY SERRA DR UNIT 3A
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City | SYKESVILLE
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State | MD
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Zip | 21784-6552
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Country | US
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Telephone | 410-991-2077
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CWO15775
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 07971
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License Number State | MD
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