Provider Demographics
NPI:1780222117
Name:KIMEMIA, VERONICA MUTHONI (PHD; LPC)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:MUTHONI
Last Name:KIMEMIA
Suffix:
Gender:F
Credentials:PHD; LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 BRIARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-6494
Mailing Address - Country:US
Mailing Address - Phone:618-203-3387
Mailing Address - Fax:
Practice Address - Street 1:1960 BRIARFIELD DR
Practice Address - Street 2:
Practice Address - City:LAKE SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-6494
Practice Address - Country:US
Practice Address - Phone:618-203-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019045776101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC266989OtherNATIONAL BOARD FOR THE CERTIFICATION OF COUNSELORS
MO2019045776OtherMISSOURI DIVISION OF PROFESIONAL REGISTRATION