=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821962473
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TO-SHERA FRIEND-KIMBLE LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2025
-----------------------------------------------------
Last Update Date | 12/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7229 FOREST AVE STE 111
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23226-3765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-687-4793
-----------------------------------------------------
Fax | 855-618-2628
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 40412
-----------------------------------------------------
City | BELFAST
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04915-1255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-687-4793
-----------------------------------------------------
Fax | 855-618-2628
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0904012647
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------