Provider Demographics
NPI:1114214020
Name:NELSON-ARRINGTON, KIMBERLY S (PSYD, PHD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:S
Last Name:NELSON-ARRINGTON
Suffix:
Gender:
Credentials:PSYD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18300 S HALSTED ST STE B
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60425-1051
Mailing Address - Country:US
Mailing Address - Phone:312-259-3166
Mailing Address - Fax:708-248-6416
Practice Address - Street 1:700 N BRUCE LN APT 307
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IL
Practice Address - Zip Code:60425-1134
Practice Address - Country:US
Practice Address - Phone:708-740-5263
Practice Address - Fax:708-248-6416
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071011441103TC0700X
IL180007628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical