Provider Demographics
NPI:1427458389
Name:PRIESTER, KIMBERLY (MS, LPCC, LICDC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:PRIESTER
Suffix:
Gender:F
Credentials:MS, LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-7738
Mailing Address - Country:US
Mailing Address - Phone:937-545-5208
Mailing Address - Fax:
Practice Address - Street 1:529 E STROOP RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3245
Practice Address - Country:US
Practice Address - Phone:937-294-6004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1000226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional