Healthcare Provider Details

I. General information

NPI: 1003740465
Provider Name (Legal Business Name): KIM STORM COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N 19TH ST STE 12
MONROE LA
71201-4942
US

IV. Provider business mailing address

612 BURGESSVILLE RD
RUSTON LA
71270-5154
US

V. Phone/Fax

Practice location:
  • Phone: 318-957-8095
  • Fax:
Mailing address:
  • Phone: 318-537-4890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMBERLY C STORM
Title or Position: MEMBER/AGENT
Credential: LPC-S
Phone: 318-537-4890