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General NPI Number Information
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NPI Number | 1508609157
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Entity Type | Organization
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Legal Business Name | KIMBERLY ALLEN
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Dates
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Enumeration Date | 06/13/2024
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 5713 SUPERIOR DR STE B3
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City | BATON ROUGE
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State | LA
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Zip | 70816-8015
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Country | US
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Telephone | 225-364-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 12805 RUBY LAKE DR
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City | WALKER
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State | LA
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Zip | 70785-3436
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Country | US
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Telephone | 225-337-6847
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY ALLEN
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Credential | LCSW
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Telephone | 225-337-6847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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