MEDICARE: ALLIYAH KIMBROUGH

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	104100000X	Social Worker	SW140883	PA
2	1041C0700X	Clinical Social Worker	CW027181	PA

General Provider Information

NPI Number	:	1588288179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLIYAH KIMBROUGH

Provider Business Mailing Address
First Line	:	332 MINTON ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15204-1857
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5844 FORWARD AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-2320
Country	:	US
Telephone Number	:	412-540-4632
Fax Number	:

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

Provider Enumeration Date	:	05/30/2020
Last Update Date	:	03/03/2026

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Directions to “ ALLIYAH KIMBROUGH ” Practice Location

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