Kimber King
Individual provider Active NPI Mental Health Counselor · Paxton, IL
NPI 1497319313 · NPPES record last updated Apr 25, 2019
Key facts
- NPI
- 1497319313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1510 W Ottawa Rd
Paxton, IL 60957-4090 - Phone
- (217) 379-4302
- Fax
- (217) 817-0379
- NPI assigned
- Apr 25, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1510 W Ottawa Rd
Paxton, IL 60957-4090
Mailing address
1510 W Ottawa Rd
Paxton, IL 60957-4090
Phone (217) 379-4302
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All providers in Paxton, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.