=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124017231
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORAH DIANE KINDER LCP LMCP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8 W 8TH AVE
-----------------------------------------------------
City | EMPORIA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66801-2904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-340-9731
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2238 REDWOOD AVE
-----------------------------------------------------
City | EMPORIA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66801-5915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-340-9731
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPC#105 LMLP292
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------