Kimberly Barham

Individual provider Active NPI Counselor · Selmer, TN

NPI 1639215569 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1639215569
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
641 E Poplar Ave
Selmer, TN 38375-1828
Phone
(731) 645-5753
Fax
(731) 645-9885
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Centers & Clinics of Tennessee Past
since Aug 30, 2017
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Yes

Addresses

Primary practice location

641 E Poplar Ave
Selmer, TN 38375-1828

Mailing address

641 E Poplar Ave
Selmer, TN 38375-1828
Phone (731) 645-5753

Other providers in Selmer, TN

All providers in Selmer, TN · Counselor in Tennessee

Sources for this page

Verify at the official NPI Registry.