Provider Demographics
NPI:1982943569
Name:CORTHELL, KIMERE K (LPC)
Entity type:Individual
Prefix:
First Name:KIMERE
Middle Name:K
Last Name:CORTHELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 GENTRYS WALK
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1245
Mailing Address - Country:US
Mailing Address - Phone:843-737-1962
Mailing Address - Fax:
Practice Address - Street 1:201 17TH ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30363-1098
Practice Address - Country:US
Practice Address - Phone:843-737-1962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-02
Last Update Date:2016-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007023101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional