Provider Demographics
NPI:1124785423
Name:SERYBY, KIMANI (LPC)
Entity type:Individual
Prefix:
First Name:KIMANI
Middle Name:
Last Name:SERYBY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3388 PRINCESS ANNE RD STE 2001
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-2612
Mailing Address - Country:US
Mailing Address - Phone:757-227-5055
Mailing Address - Fax:833-406-3955
Practice Address - Street 1:3388 PRINCESS ANNE RD STE 2001
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-2612
Practice Address - Country:US
Practice Address - Phone:757-227-5055
Practice Address - Fax:833-406-3955
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health