Provider Demographics
NPI:1154091270
Name:PARHAM, KIMBERLYN LATRICE (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLYN
Middle Name:LATRICE
Last Name:PARHAM
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6542 KOBE CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3450
Mailing Address - Country:US
Mailing Address - Phone:334-354-8665
Mailing Address - Fax:
Practice Address - Street 1:6542 KOBE CT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3450
Practice Address - Country:US
Practice Address - Phone:334-354-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty