MEDICARE: KIMBERLY LITTON LCSW, CAP

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	1041C0700X	Clinical Social Worker	13793	FL

General Provider Information

NPI Number	:	1164973301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY LITTON LCSW, CAP

Provider Business Mailing Address
First Line	:	721 US HIGHWAY 1
Second Line	:	205
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 US HIGHWAY 1
Second Line	:	205
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4512
Country	:	US
Telephone Number	:	561-319-1699
Fax Number	:

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

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	09/21/2017

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