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Individual
MRS. KIMBERLY JEAN WOODCOCK
Active
Individual
MRS. KIMBERLY JEAN WOODCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.H.C.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4694
MA
101YM0800X
Mental Health Counselor
Primary
4694
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306421
—
MA
05
—
1308785
—
MA
01
—
2220002001
BCBS SUBSTANCE ABUSE
MA
01
—
M18684
BCBS MENTAL HEALTH
MA
Enumeration date
01/19/2007
Last updated
01/15/2022
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