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General NPI Number Information
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NPI Number | 1306465703
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Entity Type | Individual
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Provider Name | KIMBERLY MAXINE GARRITY LICSW
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Gender | Female
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 2021 21ST AVE S STE C400
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City | NASHVILLE
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State | TN
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Zip | 37212-4350
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Country | US
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Telephone | 844-695-0199
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Fax |
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Provider Business Mailing Address
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Address Line | 200 WEST RD APT 30
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City | ELLINGTON
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State | CT
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Zip | 06029-3752
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Country | US
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Telephone | 860-574-0936
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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 | 4977
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 222407
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License Number State | MA
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