Provider Demographics
NPI:1235848391
Name:FIENBERG-LANDRETH, KIMBERLY (CRC, NCC, RMHCI)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:FIENBERG-LANDRETH
Suffix:
Gender:F
Credentials:CRC, NCC, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13305 MAHAN DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-8698
Mailing Address - Country:US
Mailing Address - Phone:850-893-8800
Mailing Address - Fax:
Practice Address - Street 1:13305 MAHAN DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-8698
Practice Address - Country:US
Practice Address - Phone:850-893-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health