Harris, Kimberly J

Harris, Kimberly J is an individual health care provider with primary practice located at 4464 S Dixie Hwy , Middletown OH 45005-5464. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Harris, Kimberly J can be contacted via phone (513) 649-8008.

Contact Information

Primary practice address
4464 S Dixie Hwy Middletown OH 45005-5464
Phone: (513) 649-8008
Fax: (513) 649-8004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LICDC.001245 Ohio
Behavioral Health & Social Service Providers / Mental Health 101YM0800X E.0003482-SUPV Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X E.0003482-SUPV Ohio

Profile Details

NPI number 1790990711
LBN Legal business name Harris, Kimberly J
Credentials LPCC-S, LICDC
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2007
Last updated Feb 9th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790990711 NPPES
Ohio Other H130910 MEDICARE GROUP PTAN
Ohio Other 01-0693 MEDICARE GROUP PTAN
Ohio Other 0074946 MEDICARE GROUP PTAN
Ohio Other 0074861 MEDICARE GROUP PTAN
Ohio Other 236088 MEDICARE GROUP PTAN

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