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General NPI Number Information
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NPI Number | 1134539364
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Entity Type | Organization
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Legal Business Name | KIMBALL COUNSELING PC
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 258 N MAIN ST STE A
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City | WAYNESVILLE
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State | NC
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Zip | 28786-3812
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Country | US
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Telephone | 828-246-6100
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Fax | 828-246-6100
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Provider Business Mailing Address
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Address Line | 1077 FERN TRL
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City | WAYNESVILLE
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State | NC
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Zip | 28786-9706
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Country | US
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Telephone | 828-246-6100
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Fax | 828-246-6100
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN PENNEY KIMBALL
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Credential | LCSW, CASAC
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Telephone | 828-246-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | C008384
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License Number State | NC
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