Provider Demographics
NPI:1538380258
Name:HAMLETT-BERRY, KIM WINIFRED (PHD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:WINIFRED
Last Name:HAMLETT-BERRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:HAMLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:810 VERMONT AVE NW
Mailing Address - Street 2:PUBLIC HEALTH SHG (13B)
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20420-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 VERMONT AVE NW
Practice Address - Street 2:PUBLIC HEALTH SHG (13B)
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20420-0001
Practice Address - Country:US
Practice Address - Phone:202-266-4538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001777103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical