Provider Demographics
NPI:1548521925
Name:GROPPER, KIMBERLY ANNE (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANNE
Last Name:GROPPER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 COUNTY ROAD SE 4385
Mailing Address - Street 2:
Mailing Address - City:SCROGGINS
Mailing Address - State:TX
Mailing Address - Zip Code:75480-6806
Mailing Address - Country:US
Mailing Address - Phone:808-217-5754
Mailing Address - Fax:903-860-9699
Practice Address - Street 1:2329 OKA ST
Practice Address - Street 2:
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754-5331
Practice Address - Country:US
Practice Address - Phone:808-828-1868
Practice Address - Fax:808-828-6493
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
TX1123761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker