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NPI Code Detail

MEDICARE: MRS. KIMBERLY ANNE PURVIS M.S.W.

MEDICARE: MRS. KIMBERLY ANNE PURVIS M.S.W.
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
1101Y00000XCounselor
2104100000XSocial Worker

General Provider Information

NPI Number : 1720365687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY ANNE PURVIS M.S.W.
Provider Business Mailing Address
First Line : 81 PLANTATION ST
Second Line :
City : WORCESTER
State : MA
Zip : 01604-3069
Country : US
Telephone Number : 508-765-9101
Fax Number : 508-764-4389
Provider Business Practice Location Address
First Line : 328 MAIN ST
Second Line :
City : SOUTHBRIDGE
State : MA
Zip : 01550-3794
Country : US
Telephone Number : 508-765-9101
Fax Number : 508-764-4389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2011
Last Update Date : 05/05/2017

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