Organization
KIMBERLY GEREDA PSYCHOTHERAPY & SELF-CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY GEREDA LCSW (OWNER OF PRACTICE)
(203) 525-4272
Entity
Organization
Contact information
Practice address
59 ELM ST, SUITE #500, NEW HAVEN, CT 06510-2047
(203) 525-4272
Mailing address
59 ELM ST, SUITE #500, NEW HAVEN, CT 06510-2047
(203) 525-4272
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007676
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008067075
—
CT
Enumeration date
09/26/2016
Last updated
09/26/2016
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