MEDICARE: KIMBERLY MCGINNIS LPC, CHW, CD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C.2103865	OH
2	172V00000X	Community Health Worker	CHW.001640	OH
3	374J00000X	Doula		OH

General Provider Information

NPI Number	:	1962269241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MCGINNIS LPC, CHW, CD

Provider Business Mailing Address
First Line	:	6119 RIDGEACRES DR UNIT A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4978
Country	:	US
Telephone Number	:	513-884-0297
Fax Number	:

Provider Business Practice Location Address
First Line	:	6119 RIDGEACRES DR UNIT A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4978
Country	:	US
Telephone Number	:	513-884-0297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	03/04/2024

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Directions to “ KIMBERLY MCGINNIS LPC, CHW, CD” Practice Location

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