Green, Kimberley A

Green, Kimberley A is an individual health care provider with primary practice located at 1 University Blvd Community Psychological Service, 232 Stadler Hall, Saint Louis MO 63121-4400. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Health Service is her primary health care specialty. Green, Kimberley A can be contacted via phone (314) 516-5824.

Contact Information

Primary practice address
1 University Blvd Community Psychological Service, 232 Stadler Hall Saint Louis MO 63121-4400
Phone: (314) 516-5824
Fax: (314) 516-5347
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20040602 Indiana
Behavioral Health & Social Service Providers / Health Service 103TH0100X 20040602 Indiana

Profile Details

NPI number 1821084476
LBN Legal business name Green, Kimberley A
Credentials PH.D., HSPP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Nov 26th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821084476 NPPES
Other 084081 SIHO - SOUTHEASTERN INDIANA HEALTH ORGANIZATION
Other 000000533237 SIHO - SOUTHEASTERN INDIANA HEALTH ORGANIZATION
MEDICAID 100167180A SIHO - SOUTHEASTERN INDIANA HEALTH ORGANIZATION
Other 7453298 SIHO - SOUTHEASTERN INDIANA HEALTH ORGANIZATION
Other 06010200 SIHO - SOUTHEASTERN INDIANA HEALTH ORGANIZATION

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