Provider Demographics
NPI:1548601370
Name:KIMMAN, BILLIE JO (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BILLIE
Middle Name:JO
Last Name:KIMMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 HIGHWAY 12 E STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-5811
Mailing Address - Country:US
Mailing Address - Phone:320-214-9692
Mailing Address - Fax:
Practice Address - Street 1:2320 HIGHWAY 12 E STE 2
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-5811
Practice Address - Country:US
Practice Address - Phone:320-214-9692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2585101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health