Kimball, Leslie A.

Kimball, Leslie A. is an individual health care provider with primary practice located at 1308 Sherwood Ave , Richmond VA 23220-1210. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kimball, Leslie A. can be contacted via phone (804) 828-3129.

Contact Information

Primary practice address
1308 Sherwood Ave Richmond VA 23220-1210
Fax: (804) 828-9493
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 0810003386 Virginia
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810003386 Virginia

Profile Details

NPI number 1134209349
LBN Legal business name Kimball, Leslie A.
Credentials PH.D, LCP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Jul 21st, 2020 - about 5 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 1134209349 NPPES
Virginia MEDICAID 010144329 541581185

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