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Provider Information for 1861522831


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KIM LYMAN M.S., LMHC


Sex: Female

NPI: 1861522831
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1861522831
Enumeration Date2007-03-07
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1419 HANCOCK ST STE 302
QUINCY, MA 02169-5250
United States

Phone: 617-843-3179 | Fax:
 
Primary Practice Address 1419 HANCOCK ST STE 302
QUINCY, MA 02169-5250
United States

Phone: 617-843-3179 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDMA1893459
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthMA5916