Provider Demographics
NPI:1205923075
Name:ARTER, KIM R (LMHP, CPC)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:R
Last Name:ARTER
Suffix:
Gender:F
Credentials:LMHP, CPC
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:R
Other - Last Name:TEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11414 W CENTER RD STE 239
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4487
Mailing Address - Country:US
Mailing Address - Phone:402-330-1633
Mailing Address - Fax:
Practice Address - Street 1:11414 W CENTER RD STE 239
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4487
Practice Address - Country:US
Practice Address - Phone:402-330-1633
Practice Address - Fax:402-370-3370
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3137101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3137OtherLICENSE #