Provider Demographics
NPI:1306130927
Name:KIMBERLY ARVIN, LCSW, ACSW LLC
Entity type:Organization
Organization Name:KIMBERLY ARVIN, LCSW, ACSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, ACSW
Authorized Official - Phone:812-598-4960
Mailing Address - Street 1:815 JOHN ST
Mailing Address - Street 2:SUITE 110-G
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-2746
Mailing Address - Country:US
Mailing Address - Phone:812-598-4960
Mailing Address - Fax:812-425-2585
Practice Address - Street 1:815 JOHN ST
Practice Address - Street 2:SUITE 110-G
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-2746
Practice Address - Country:US
Practice Address - Phone:812-598-4960
Practice Address - Fax:812-425-2585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004923A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health