Provider Demographics
NPI:1942062500
Name:MYERS, KIMBERLEE (LMSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 S HIGLEY RD STE 113
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-4789
Mailing Address - Country:US
Mailing Address - Phone:480-339-7119
Mailing Address - Fax:480-855-7991
Practice Address - Street 1:1355 S HIGLEY RD STE 113
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4789
Practice Address - Country:US
Practice Address - Phone:480-339-7119
Practice Address - Fax:480-855-7991
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW18155104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker