Provider Demographics
NPI:1588105514
Name:WESTPHALL, KIMBERLY ANN (LICSW, SUDP-T)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:WESTPHALL
Suffix:
Gender:F
Credentials:LICSW, SUDP-T
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:104 S FREYA ST STE 212
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4871
Mailing Address - Country:US
Mailing Address - Phone:509-368-9863
Mailing Address - Fax:509-587-1575
Practice Address - Street 1:104 S FREYA ST STE 212
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4871
Practice Address - Country:US
Practice Address - Phone:509-368-9863
Practice Address - Fax:509-587-1575
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61447243101YA0400X
WALW615562271041C0700X
WASA60751611104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical