Provider Demographics
NPI:1679914576
Name:JOHNSON, KIMBERLY BEST (LPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BEST
Last Name:JOHNSON
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 1:7008 BRINLEY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-6246
Mailing Address - Country:US
Mailing Address - Phone:804-901-5628
Mailing Address - Fax:804-507-0122
Practice Address - Street 1:550 SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3043
Practice Address - Country:US
Practice Address - Phone:804-901-5628
Practice Address - Fax:804-507-0122
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005501101YP2500X
VA0717001304106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist