Jan S Kimball, LPCC
Counselor in Mentor, OH. Individual provider (NPI-1).
NPI number1679023402
StatusActive
Last updated in NPPESJun 29, 2021
Details
- NPI
- 1679023402
- Entity type
- Individual (NPI-1)
- Name
- Ms. Jan S Kimball
- Credential
- LPCC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 5, 2016
- Certification date
- Jun 29, 2021
- Last updated
- Jun 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | E.0008013 | OH | Yes |
| 101YP2500X | Counselor, Professional | E0008013 | OH |
Practice location
7232 Justin WayMentor, OH 44060-4881
Phone 440-578-8200
Mailing address
7232 Justin WayMentor, OH 44060-4881
Phone 440-578-8200
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