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General NPI Number Information
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NPI Number | 1295360246
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Entity Type | Organization
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Legal Business Name | KIMBERLY RICHARDS COUNSELING, LLC
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Dates
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Enumeration Date | 03/10/2020
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Last Update Date | 03/10/2020
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Provider Practice Location Address
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Address Line | 29 NW GREELEY AVE
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City | BEND
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State | OR
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Zip | 97703-2911
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Country | US
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Telephone | 541-419-9949
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 NE FORUM DR APT 44
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City | BEND
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State | OR
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Zip | 97701-5306
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Country | US
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Telephone | 541-419-9949
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | KIMBERLY MICHELLE RICHARDS
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Credential | LPC
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Telephone | 541-419-9949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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