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NPI Code Detail

MEDICARE: KIMBERLY K PERRY MS, NCC, LPC

MEDICARE: KIMBERLY K PERRY MS, NCC, LPC
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
1101YP2500XProfessional Counselor6401223343MI
2101YP2500XProfessional Counselor3167-125WI

General Provider Information

NPI Number : 1982761219
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY K PERRY MS, NCC, LPC
Provider Business Mailing Address
First Line : PO BOX 22040
Second Line :
City : GREEN BAY
State : WI
Zip : 54305-2040
Country : US
Telephone Number : 920-445-7210
Fax Number : 920-445-7289
Provider Business Practice Location Address
First Line : 1630 COMMANCHE AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54313-5753
Country : US
Telephone Number : 920-430-4780
Fax Number : 920-430-4787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 12/05/2025

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