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General NPI Number Information
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NPI Number | 1770720583
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Entity Type | Individual
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Provider Name | KIMBERLY ANN FAILES MS LPC LAT
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Gender | Female
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 378 FALLS AVE
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City | TWIN FALLS
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State | ID
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Zip | 83301-3373
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Country | US
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Telephone | 208-293-8062
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Fax | 208-293-8082
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Provider Business Mailing Address
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Address Line | 378 FALLS AVE
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City | TWIN FALLS
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State | ID
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Zip | 83301-3373
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Country | US
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Telephone | 208-293-8062
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Fax | 208-293-8082
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LAT 269
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC 732
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LCPC 5870
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCPC 5870
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCPC 5870
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC 5870
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License Number State | ID
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Taxonomy #7
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC732
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License Number State | WY
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Taxonomy #8
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LAT 269
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License Number State | WY
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Taxonomy #9
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC 732
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License Number State | WY
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