Basic Information
Provider Information
NPI: 1538685516
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIHL
FirstName: KIMBERLY
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10401 LINN STATION RD STE 100
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402233842
CountryCode: US
TelephoneNumber: 5025898600
FaxNumber: 5025898745
Practice Location
Address1: 11103 PARK RD
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402232424
CountryCode: US
TelephoneNumber: 5892454171
FaxNumber: 5022457447
Other Information
ProviderEnumerationDate: 08/21/2017
LastUpdateDate: 03/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X276533KYY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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