Provider Demographics
NPI:1699182071
Name:BURROW, KIM LEE (LICSW)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:LEE
Last Name:BURROW
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:LEE
Other - Last Name:LARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:516 63RD AVENUE CT NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-4071
Mailing Address - Country:US
Mailing Address - Phone:253-590-6946
Mailing Address - Fax:
Practice Address - Street 1:516 63RD AVENUE CT NE # WA
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-4071
Practice Address - Country:US
Practice Address - Phone:253-590-6946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00009672104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical