Basic Information
Provider Information
NPI: 1750621447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVEY
FirstName: KIMBERLY
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HIRST
OtherFirstName: KIMBERLY
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MA
OtherLastNameType: 1
Mailing Information
Address1: 240 N TILLOTSON AVE
Address2:  
City: MUNCIE
State: IN
PostalCode: 473043988
CountryCode: US
TelephoneNumber: 7652881928
FaxNumber: 7657410335
Practice Location
Address1: 1547 OHIO AVE
Address2:  
City: ANDERSON
State: IN
PostalCode: 460161917
CountryCode: US
TelephoneNumber: 7656417499
FaxNumber: 7653564647
Other Information
ProviderEnumerationDate: 02/18/2013
LastUpdateDate: 05/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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