Provider Demographics
NPI:1891877080
Name:BERRY-LAVOIE, KIMBERLY A (MED, LMFT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:BERRY-LAVOIE
Suffix:
Gender:F
Credentials:MED, LMFT
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:BERRY-LAVOIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED,LMFT
Mailing Address - Street 1:4206 MCCAMPBELL LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2725
Mailing Address - Country:US
Mailing Address - Phone:865-742-7157
Mailing Address - Fax:865-244-1096
Practice Address - Street 1:3232 TAZEWELL PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2529
Practice Address - Country:US
Practice Address - Phone:865-742-7157
Practice Address - Fax:865-244-1096
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health