Provider Demographics
NPI:1467948224
Name:MURRELL, KIMBERLY MICAELA (NCC, LPCA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MICAELA
Last Name:MURRELL
Suffix:
Gender:F
Credentials:NCC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9617 ROTHMAN LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-7307
Mailing Address - Country:US
Mailing Address - Phone:704-249-6226
Mailing Address - Fax:
Practice Address - Street 1:9617 ROTHMAN LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-7307
Practice Address - Country:US
Practice Address - Phone:704-249-6226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13928101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional