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NPI Code Detail

MEDICARE: KIMBERLY FIENBERG-LANDRETH CRC, NCC, RMHCI

MEDICARE: KIMBERLY FIENBERG-LANDRETH CRC, NCC, RMHCI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH25083FL

General Provider Information

NPI Number : 1235848391
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY FIENBERG-LANDRETH CRC, NCC, RMHCI
Provider Business Mailing Address
First Line : 110 MELALEUCA DR
Second Line :
City : CRAWFORDVILLE
State : FL
Zip : 32327-4963
Country : US
Telephone Number : 850-671-9284
Fax Number :
Provider Business Practice Location Address
First Line : 13305 MAHAN DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-8698
Country : US
Telephone Number : 850-893-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2022
Last Update Date : 03/13/2026

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