Provider Demographics
NPI:1790065829
Name:ENDRES, KIMBERLY RENEE (LMHC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RENEE
Last Name:ENDRES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:RENEE
Other - Last Name:MUHLBAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 1743
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-0662
Mailing Address - Country:US
Mailing Address - Phone:401-500-5836
Mailing Address - Fax:401-679-9891
Practice Address - Street 1:215 SHADY HILL DR
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1403
Practice Address - Country:US
Practice Address - Phone:401-500-5836
Practice Address - Fax:401-679-9891
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-21
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health