Provider Demographics
NPI:1801015466
Name:LINER, KIMBERLY JOHNSON (LPC-S, LMFT, NCC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JOHNSON
Last Name:LINER
Suffix:
Gender:F
Credentials:LPC-S, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 JACKSON ST EXT STE C-418
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2042
Mailing Address - Country:US
Mailing Address - Phone:318-471-6551
Mailing Address - Fax:
Practice Address - Street 1:5720 JACKSON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2042
Practice Address - Country:US
Practice Address - Phone:318-471-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2745101YM0800X
LA728106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist