Provider Demographics
NPI:1063883957
Name:KIMBALL, ALICIA (LCSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 N ROSELLE RD STE 800
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195-3186
Mailing Address - Country:US
Mailing Address - Phone:847-220-7603
Mailing Address - Fax:
Practice Address - Street 1:1901 N ROSELLE RD STE 800
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-3186
Practice Address - Country:US
Practice Address - Phone:847-220-7603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-17
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical