=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881487361
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIMBERLY THORSEN LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2025
-----------------------------------------------------
Last Update Date | 05/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1714 LINCOLN WAY
-----------------------------------------------------
City | WHITE OAK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15131-1716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-420-7143
-----------------------------------------------------
Fax | 724-221-3801
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11633 PERCHERON CIR
-----------------------------------------------------
City | NORTH HUNTINGDON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15642-6746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-309-5574
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | PC018490
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------