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General NPI Number Information
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NPI Number | 1790020402
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Entity Type | Individual
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Provider Name | KIMBERLY L HEBERT LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 770 BAYOU PINES EAST DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7184
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Country | US
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Telephone | 337-477-4770
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Fax | 337-477-0508
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Provider Business Mailing Address
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Address Line | 770 BAYOU PINES EAST DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7184
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Country | US
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Telephone | 337-477-4770
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Fax | 337-477-0508
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10129
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License Number State | LA
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