Provider Demographics
NPI:1003096702
Name:SINGH, KIMBERLY LYNN (MA,LMHC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LYNN
Last Name:SINGH
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LYNN
Other - Last Name:ARBUCKLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MALMHC
Mailing Address - Street 1:7406 27TH ST W STE 1
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4635
Mailing Address - Country:US
Mailing Address - Phone:253-691-3945
Mailing Address - Fax:
Practice Address - Street 1:7406 27TH ST W STE 1
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4635
Practice Address - Country:US
Practice Address - Phone:253-691-3945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60227238101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA202012Medicaid