Healthcare Provider Details

I. General information

NPI: 1922925437
Provider Name (Legal Business Name): KIMBERLY HEMING LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17912 51ST ST NW
VAUGHN WA
98394-9600
US

IV. Provider business mailing address

17912 51ST ST NW
VAUGHN WA
98394-9600
US

V. Phone/Fax

Practice location:
  • Phone: 650-265-1193
  • Fax:
Mailing address:
  • Phone: 650-265-1193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70100715
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: