Provider Demographics
NPI:1215554944
Name:SADEGI, KIMBERLY HALL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:HALL
Last Name:SADEGI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10069 N 107TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-6093
Mailing Address - Country:US
Mailing Address - Phone:480-205-9944
Mailing Address - Fax:
Practice Address - Street 1:10069 N 107TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-6093
Practice Address - Country:US
Practice Address - Phone:480-205-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13846101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional