Provider Demographics
NPI:1700757697
Name:HOWELL, KIMBERLEA DAWN
Entity type:Individual
Prefix:
First Name:KIMBERLEA
Middle Name:DAWN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DOCTORS DR STE A
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4486
Mailing Address - Country:US
Mailing Address - Phone:770-812-8863
Mailing Address - Fax:
Practice Address - Street 1:101 DOCTORS DR STE A
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4486
Practice Address - Country:US
Practice Address - Phone:770-812-8863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health