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NPI Code Detail

MEDICARE: KIMBERLY BRYAN LCSW

MEDICARE: KIMBERLY BRYAN LCSW
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
11041C0700XClinical Social WorkerC017866NC

General Provider Information

NPI Number : 1225684921
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY BRYAN LCSW
Provider Business Mailing Address
First Line : 1229 GATEHOUSE DR
Second Line :
City : CARY
State : NC
Zip : 27511-5157
Country : US
Telephone Number : 303-898-3904
Fax Number :
Provider Business Practice Location Address
First Line : 136 US 70 HWY E
Second Line :
City : GARNER
State : NC
Zip : 27529-3982
Country : US
Telephone Number : 919-791-5611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2019
Last Update Date : 01/22/2025

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Directions to “ KIMBERLY BRYAN LCSW” Practice Location

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