Provider Demographics
NPI:1407409758
Name:ROWE, KIMBERLY FAYE (LPCA, MED)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:FAYE
Last Name:ROWE
Suffix:
Gender:F
Credentials:LPCA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 WELLINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-5136
Mailing Address - Country:US
Mailing Address - Phone:270-559-4095
Mailing Address - Fax:
Practice Address - Street 1:2820 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4170
Practice Address - Country:US
Practice Address - Phone:270-442-5738
Practice Address - Fax:270-442-3172
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health