Provider Demographics
NPI:1457142457
Name:MERLENBACH, KIMBERLY MAE (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MAE
Last Name:MERLENBACH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:MAE
Other - Last Name:WALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2705 SAINT PETERS HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2821
Mailing Address - Country:US
Mailing Address - Phone:636-866-9368
Mailing Address - Fax:
Practice Address - Street 1:2705 SAINT PETERS HOWELL RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2821
Practice Address - Country:US
Practice Address - Phone:636-866-9368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025017208101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional