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General NPI Number Information
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NPI Number | 1881342574
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Entity Type | Individual
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Provider Name | KIMBERLEIGH STICKNEY LCMHC
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Gender | Female
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Dates
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Enumeration Date | 03/12/2022
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Last Update Date | 03/13/2022
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Provider Practice Location Address
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Address Line | 13867 COCOANUT AVE
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City | JUNO BEACH
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State | FL
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Zip | 33408-1617
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Country | US
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Telephone | 561-344-8959
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Fax |
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Provider Business Mailing Address
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Address Line | 13867 COCOANUT AVE
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City | JUNO BEACH
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State | FL
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Zip | 33408-1617
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH20043
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 17447
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License Number State | NC
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