Provider Demographics
NPI:1699328153
Name:KIM YKEMA COUNSELING PLLC
Entity type:Organization
Organization Name:KIM YKEMA COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLE
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:YKEMA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-504-3784
Mailing Address - Street 1:908 GEORGIANA ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3912
Mailing Address - Country:US
Mailing Address - Phone:360-504-3784
Mailing Address - Fax:360-504-3984
Practice Address - Street 1:908 GEORGIANA ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3912
Practice Address - Country:US
Practice Address - Phone:360-504-3784
Practice Address - Fax:360-504-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty