Provider Demographics
NPI:1851890438
Name:BROWN, KIMBERLY SUE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SUE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:SUE
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:792 GREY HAWK DRIVE
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-9028
Mailing Address - Country:US
Mailing Address - Phone:775-874-4116
Mailing Address - Fax:775-874-4116
Practice Address - Street 1:1044 INGLEWOOD DRIVE STE. 207
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9327
Practice Address - Country:US
Practice Address - Phone:775-874-4116
Practice Address - Fax:775-688-1230
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NV9627-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health