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General NPI Number Information
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NPI Number | 1942353438
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Entity Type | Individual
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Provider Name | KIMBERLY JEAN WOODCOCK L.M.H.C.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 01/15/2022
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Provider Practice Location Address
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Address Line | 165 MAIN ST UNIT 213
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City | MEDWAY
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State | MA
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Zip | 02053-1584
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Country | US
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Telephone | 508-320-5165
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Fax | 508-519-0051
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Provider Business Mailing Address
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Address Line | 165 MAIN ST UNIT 213
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City | MEDWAY
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State | MA
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Zip | 02053-1584
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Country | US
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Telephone | 508-320-5165
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Fax | 508-519-0051
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4694
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 4694
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License Number State | MA
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