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General NPI Number Information
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NPI Number | 1114012291
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Entity Type | Individual
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Provider Name | KIMBERLY STINES SHEETS LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23265 PIONEER DR
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City | BRISTOL
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State | VA
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Zip | 24202-1533
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Country | US
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Telephone | 276-466-4292
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Fax | 276-466-8938
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Provider Business Mailing Address
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Address Line | 23265 PIONEER DR
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City | BRISTOL
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State | VA
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Zip | 24202-1533
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Country | US
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Telephone | 276-466-4292
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Fax | 276-466-8938
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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 | 0904006417
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License Number State | VA
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