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General NPI Number Information
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NPI Number | 1427317866
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Entity Type | Individual
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Provider Name | KIMBERLY S HARRELL M.ED., LPC
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Gender | Female
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 501 CHURCH ST NE STE. 209
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City | VIENNA
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State | VA
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Zip | 22180-4734
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Country | US
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Telephone | 571-208-7864
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Fax |
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Provider Business Mailing Address
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Address Line | 6913 RIDGE WATER CT
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City | CENTREVILLE
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State | VA
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Zip | 20121-5714
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Country | US
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Telephone | 703-282-4286
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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 | 0701004816
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License Number State | VA
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