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General NPI Number Information
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NPI Number | 1609271329
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Entity Type | Individual
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Provider Name | KIMBERLY MINTON LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1 RICHMOND SQ STE 350W
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City | PROVIDENCE
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State | RI
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Zip | 02906-5165
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Country | US
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Telephone | 401-441-5834
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Fax | 401-210-8248
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Provider Business Mailing Address
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Address Line | 17 WARREN CT
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City | CRANSTON
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State | RI
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Zip | 02920-1542
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Country | US
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Telephone | 907-854-5362
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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 | 122302
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License Number State | MA
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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 | ISW03721
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License Number State | RI
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