Provider Demographics
NPI:1215643960
Name:KING, KIMBERLY LYNN-LEWIS (LPC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LYNN-LEWIS
Last Name:KING
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 1:2118 WAMPLERS HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-9573
Mailing Address - Country:US
Mailing Address - Phone:517-795-0114
Mailing Address - Fax:
Practice Address - Street 1:2118 WAMPLERS HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-9573
Practice Address - Country:US
Practice Address - Phone:517-795-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional