Provider Demographics
NPI:1649575887
Name:WILLIAMS, KIMBERLY ELLIFF (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ELLIFF
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 STONEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4532
Mailing Address - Country:US
Mailing Address - Phone:804-545-2487
Mailing Address - Fax:
Practice Address - Street 1:14410 SOMMERVILLE CT
Practice Address - Street 2:STE 101
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6813
Practice Address - Country:US
Practice Address - Phone:804-897-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004953101YP2500X
TX15228101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional