Provider Demographics
NPI:1184974867
Name:YORE, KIMBERLEY LYNN (MS, LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:LYNN
Last Name:YORE
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:LYNN
Other - Last Name:YORECUTCHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:4029 WEST MAIN ST. (4029)
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2763
Mailing Address - Country:US
Mailing Address - Phone:269-290-4359
Mailing Address - Fax:269-397-2287
Practice Address - Street 1:4029 WEST MAIN ST. (4029)
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2763
Practice Address - Country:US
Practice Address - Phone:269-290-4359
Practice Address - Fax:269-397-2287
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703102803164W00000X
MI6401011301101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No164W00000XNursing Service ProvidersLicensed Practical Nurse