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General NPI Number Information
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NPI Number | 1346660511
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Entity Type | Individual
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Provider Name | KIMBERLY HESJEDAL LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 16556 W SAMANTHA WAY
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City | GOODYEAR
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State | AZ
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Zip | 85338-1450
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Country | US
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Telephone | 623-887-4968
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Fax |
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Provider Business Mailing Address
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Address Line | 16556 W SAMANTHA WAY
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City | GOODYEAR
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State | AZ
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Zip | 85338-1450
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Country | US
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Telephone | 623-887-4968
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Fax | 480-302-7884
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW-13790
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License Number State | AZ
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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 | LCSW-22507
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License Number State | AZ
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