Provider Demographics
NPI:1649167719
Name:CAMPBELL, KIMBERLY SUE (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SUE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:SUE
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC04925
Mailing Address - Street 1:8515 ROWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-2048
Mailing Address - Country:US
Mailing Address - Phone:913-481-7003
Mailing Address - Fax:
Practice Address - Street 1:1201 N 67TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-3054
Practice Address - Country:US
Practice Address - Phone:913-481-7003
Practice Address - Fax:913-481-7003
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCP04925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health