Kimball, Lisa C

Kimball, Lisa C is an individual health care provider with primary practice located at 83 Mallard Rd , Madison ME 04950. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kimball, Lisa C can be contacted via phone (207) 474-3093.

Contact Information

Primary practice address
83 Mallard Rd Madison ME 04950
Phone: (207) 474-3093
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LC7074 Maine

Profile Details

NPI number 1871704676
LBN Legal business name Kimball, Lisa C
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated Jul 8th, 2007 - about 18 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 1871704676 NPPES
Maine MEDICAID 24593099
Maine Other ME1814

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