Healthcare Provider Details

I. General information

NPI: 1912715566
Provider Name (Legal Business Name): KIMBERLY BROWN COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 INGLEWOOD DR STE 207
FERNLEY NV
89408-9327
US

IV. Provider business mailing address

792 GREY HAWK DR
FERNLEY NV
89408-9028
US

V. Phone/Fax

Practice location:
  • Phone: 775-874-4116
  • Fax:
Mailing address:
  • Phone: 775-874-4116
  • Fax: 775-874-4116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY SUE BROWN
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 775-874-4116