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General NPI Number Information
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NPI Number | 1114671807
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Entity Type | Individual
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Provider Name | KIMBERLY M MEEK
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Gender | Female
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1067 E BRANDON BLVD
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City | BRANDON
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State | FL
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Zip | 33511-5515
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Country | US
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Telephone | 813-548-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 710 VANDERBAKER RD
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-7867
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Country | US
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Telephone | 813-418-1966
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 23440
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License Number State | FL
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