Provider Demographics
NPI:1972680056
Name:MARABLE, KIMBERLY LAJUAN (LPC, NCC, CRC)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:LAJUAN
Last Name:MARABLE
Suffix:
Gender:F
Credentials:LPC, NCC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2749 BENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2173
Mailing Address - Country:US
Mailing Address - Phone:205-533-8667
Mailing Address - Fax:205-533-7481
Practice Address - Street 1:1675 MONTCLAIR RD STE 252
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35210-2400
Practice Address - Country:US
Practice Address - Phone:205-567-4718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2362101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL339037264Medicaid