Healthcare Provider Details

I. General information

NPI: 1407091200
Provider Name (Legal Business Name): KIMBERLY S ROE LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2008
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 CLINTON AVE
ASHEVILLE NC
28806-2458
US

IV. Provider business mailing address

195 CLINTON AVE
ASHEVILLE NC
28806-2458
US

V. Phone/Fax

Practice location:
  • Phone: 828-367-7309
  • Fax:
Mailing address:
  • Phone: 828-367-7309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7154
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: