MEDICARE: KIMBERLY GREEN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	PC009652	PA
2	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073025987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY GREEN LPC

Provider Business Mailing Address
First Line	:	4012 BRUNSWICK AVE
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-3406
Country	:	US
Telephone Number	:	610-931-3650
Fax Number	:

Provider Business Practice Location Address
First Line	:	4012 BRUNSWICK AVE
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-3406
Country	:	US
Telephone Number	:	610-931-3650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2017
Last Update Date	:	08/21/2024

Similar Medicare Providers

1730766031 — MRS. BRANDELYN MARTINA HANKINS MS
Practice Location Address:

4022 BRUNSWICK AVE
DREXEL HILL, PA
19026-3406

Practice Phone: 610-908-5914
Practice Fax:

1790404317 — MIND, BODY AND SOUL COUNSELING LLC
Practice Location Address:

4022 BRUNSWICK AVE
DREXEL HILL, PA
19026-3406

Practice Phone: 484-938-8495
Practice Fax:

1861292476 — EVERWELL CARE LLC
Practice Location Address:

4006 BRUNSWICK AVE
DREXEL HILL, PA
19026-3406

Practice Phone: 267-370-4829
Practice Fax:

1356209654 — FRANCHESKA MICHELLE VELEZ MELENDEZ COTA
Practice Location Address:

4543 PLEASANT HILL RD SPC A
KISSIMMEE, FL
34759-3406

Practice Phone: 407-846-1400
Practice Fax:

1801871736 — DR. KRISTIN B WEBB PSY.D.
Practice Location Address:

105 DEERWOOD CT
CHAPEL HILL, NC
27517-3406

Practice Phone: 919-225-1569
Practice Fax:

1972513893 — DR. MONTENIQUE FINNEY PH.D.
Practice Location Address:

4800 PLEASANT HILL DR , STE 202
ROANOKE, VA
24018-3406

Practice Phone: 540-206-3800
Practice Fax: 540-206-2990

Directions to “ KIMBERLY GREEN LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.