Kimberk, Theresa

Kimberk, Theresa is an individual health care provider with primary practice located at 14 Fordham Rd , Allston MA 02134-3006. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Kimberk, Theresa can be contacted via phone (617) 782-6460.

Contact Information

Primary practice address
14 Fordham Rd Allston MA 02134-3006
Phone: (617) 782-6460
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 1952 Massachusetts

Profile Details

NPI number 1750409124
LBN Legal business name Kimberk, Theresa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2007
Last updated Jul 8th, 2007 - about 17 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 1750409124 NPPES
Massachusetts Other 1001510 BEACON NHP
Massachusetts Other 691470 BEACON NHP
Massachusetts Other 1319744 BEACON NHP
Massachusetts Other 009319 BEACON NHP
Massachusetts Other M18813 BEACON NHP
Massachusetts Other 782170 BEACON NHP
Massachusetts Other 000000008411 BEACON NHP
Massachusetts MEDICAID 1319744 BEACON NHP

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