MEDICARE: KIMBERLY L ALLISON LMHC, NCC

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
1	101YM0800X	Mental Health Counselor	MH17929	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871118463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY L ALLISON LMHC, NCC

Provider Business Mailing Address
First Line	:	1454 MADISON AVE W
Second Line	:
City	:	IMMOKALEE
State	:	FL
Zip	:	34142-2200
Country	:	US
Telephone Number	:	239-658-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6350 DAVIS BLVD # 1001
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-5323
Country	:	US
Telephone Number	:	239-658-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	04/08/2024

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