Provider Demographics
NPI:1760717540
Name:DIRE', KIM R (LPC, MED, SEP, DBH)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:R
Last Name:DIRE'
Suffix:
Gender:F
Credentials:LPC, MED, SEP, DBH
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:R
Other - Last Name:LIPSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, MED, SEP, DBH
Mailing Address - Street 1:10613 N. HAYDEN RD, SUITE J-100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-206-4646
Mailing Address - Fax:
Practice Address - Street 1:10613 N. HAYDEN RD, SUITE J-100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-206-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13344101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional