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General NPI Number Information
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NPI Number | 1306491238
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Entity Type | Individual
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Provider Name | KIMBERLY K. HEARN LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1400 N US HIGHWAY 441 STE 553
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City | THE VILLAGES
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State | FL
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Zip | 32159-8987
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Country | US
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Telephone | 833-769-3524
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Fax |
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Provider Business Mailing Address
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Address Line | 1430 WILKINS CIR
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City | CASPER
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State | WY
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Zip | 82601-1336
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Country | US
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Telephone | 307-237-9583
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1795
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License Number State | WY
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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 | MH24296
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License Number State | FL
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