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NPI Code Detail

MEDICARE: KIMBERLY ALLEN LPC-S, LMFT

MEDICARE: KIMBERLY ALLEN LPC-S, LMFT
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
1106H00000XMarriage & Family Therapist1130LA
2101YP2500XProfessional Counselor4051LA

General Provider Information

NPI Number : 1982132080
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ALLEN LPC-S, LMFT
Provider Business Mailing Address
First Line : 7539 PINE BLUFF RD
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-1234
Country : US
Telephone Number : 225-788-0988
Fax Number :
Provider Business Practice Location Address
First Line : 4917 S SHERWOOD FRST
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-4642
Country : US
Telephone Number : 225-788-0988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2017
Last Update Date : 06/01/2017

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