Kimberly Lake, BA, CAAR

Primary specialty

CounselorTaxonomy code 101Y00000X

License

608708781 Issued in WA

Practice address

720 14TH Avenue
Longview, WA 98632

Phone

(360) 423-0203

Fax

(360) 423-2311

NPI assigned

Oct 1, 2018

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

• Kimberly Hawkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

Practice roles

Locations

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.

• Columbia Wellness

  • Case Management Agency
  • Longview, WA
  • NPI 1487659579
  NPD

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1811472277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-423-0203",
            "fax_number": "360-423-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "KIMBERLY",
        "credential": "BA, CAAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "608708781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HAWKINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandon Laborico, BA
• Denny Michael Lafountaine, LMT
• Simon Thomas Lai, MD
• Lake Sacajawea Counseling
• Kennady Lake, AAC, CPC
• Lakeshore Mind and Family PLLC
• Kylee Lamb, LPN
• Wynell Lealynne Lamoreaux, BS, AAC
• Kylee Brook Lancaster, SUDP-T
• Lance D Brigman, MD, PS

• Counselor in Longview, WA
• Providers in Longview, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.