Daniel J Kimball, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3916 Issued in LA

Practice address

905 Jefferson St
Ste 410
Lafayette, LA 70501-7900

Phone

(337) 234-4912

Fax

(337) 234-6064

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lafayette Psychology Center, LLC

  • Clinical Psychologist
  • Lafayette, LA
  • NPI 1396238275
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1255439535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 JEFFERSON ST",
            "address_2": "STE 410",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705017900",
            "telephone_number": "337-234-4912",
            "fax_number": "337-234-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 JEFFERSON ST",
            "address_2": "STE 410",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705017900",
            "telephone_number": "337-234-4912",
            "fax_number": "337-234-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "3916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Killingsworth, MS
• Kim a Hardey a Professional Medical Corporation
• Kim Thomas Judice, DDS Family Dentistry
• Kyu Won Kim, RPH
• Baylen Gregory Kimball, M.D.
• Terry R. Kimball, ATC, LAT
• Angel Kimble
• Jenna Kimmel, FNP-C
• Robyn Kincel, LCSW
• Ernest Washington Kinchen, M.D.

• Mental Health Counselor in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.