Mollie A Kimball, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005940-1 Issued in NY

Practice address

5700 W Grace St Ste 108
Richmond, VA 23226-1832

Phone

(804) 442-3116

NPI assigned

Jan 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mollie Bender Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Rubenzahl, Knudsen & Associates Psych., Srvcs, P.C.

  • Psychologist
  • Watertown, NY
  • NPI 1578552170
  NPD (past)

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1801332010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W GRACE ST STE 108",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261832",
            "telephone_number": "804-442-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GRACE ST STE 108",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261832",
            "telephone_number": "804-442-3116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22670 Summit Dr",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136017208",
            "country_code": "US",
            "telephone_number": "315-788-3332",
            "fax_number": "315-788-4584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "MOLLIE",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005940-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLIE",
            "last_name": "BENDER",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Seong Kim, MPA
• Sung Cheol Kim, PMHNP
• Timothy Suyong Kim, MD
• William Tae-Shick Kim, MD
• Leslie A. Kimball, PH.D, LCP
• Pamela Marie Kimball, PH.D.
• Rebecca Lutz Kimball, MD, MS
• Charlene Avis Kimble, CSAC
• Tiffany Nicole Kimbrough, MD
• Kin Behavioral Group LLC

• Mental Health Counselor in Richmond, VA
• Providers in Richmond, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.