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General NPI Number Information
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NPI Number | 1114460011
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Entity Type | Individual
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Provider Name | KIMBERLY STRATTON LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 260 S MARION AVE STE 135
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City | LAKE CITY
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State | FL
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Zip | 32025-7000
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Country | US
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Telephone | 386-965-6901
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Fax |
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Provider Business Mailing Address
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Address Line | 796 SW HUNTER RD
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City | LAKE CITY
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State | FL
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Zip | 32024-2939
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Country | US
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Telephone | 386-965-6901
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Fax | 386-406-8348
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH14210
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License Number State | FL
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