Provider Demographics
NPI:1003829607
Name:BATT, KIMBERLY L (LCPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:BATT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:L
Other - Last Name:BATT-LINCOLN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:PO BOX 1394
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638-1394
Mailing Address - Country:US
Mailing Address - Phone:208-634-7272
Mailing Address - Fax:208-634-4588
Practice Address - Street 1:301 DEINHARD LN
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-4703
Practice Address - Country:US
Practice Address - Phone:208-634-7272
Practice Address - Fax:208-634-4588
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDL.C.P.C. 218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health