NPI Code Detail JSON Logo

1679993877 NPI number — KERI LYNN WIMBERLY-BROWN MS, LCAC, CADAC IV

NPI Number: 1679993877
Health Care Provider/Practitioner: KERI LYNN WIMBERLY-BROWN MS, LCAC, CADAC IV

Information about “1679993877” NPI (KERI LYNN WIMBERLY-BROWN MS, LCAC, CADAC IV) exists in 1679993877 in HTML format HTML  |  1679993877 in plain Text format TXT  |  1679993877 in PDF (Portable Document Format) PDF  |  1679993877 in an XML format XML  formats.

NPI Number : 1679993877 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679993877",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WIMBERLY-BROWN",
    "FirstName": "KERI",
    "MiddleName": "LYNN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, LCAC, CADAC IV",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WIMBERLY",
    "OtherFirstName": "KERI",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "MS, LCAC, CADAC IV",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2575 CHASEWAY CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INDIANAPOLIS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46268-1285",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-908-6624",
    "MailingAddressFaxNumber": "317-641-0434",
    "FirstLinePracticeLocationAddress": "2575 CHASEWAY CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANAPOLIS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46268-1285",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-908-6624",
    "PracticeLocationAddressFaxNumber": "317-641-0434",
    "EnumerationDate": "04/27/2014",
    "LastUpdateDate": "04/27/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "87001136A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.