Provider Demographics
NPI:1457409690
Name:DUVALL, L. KIM (MA, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:L.
Middle Name:KIM
Last Name:DUVALL
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S MOREY RD
Mailing Address - Street 2:STE. B
Mailing Address - City:LAKE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49651-8670
Mailing Address - Country:US
Mailing Address - Phone:517-673-0553
Mailing Address - Fax:231-295-1096
Practice Address - Street 1:1501 S MOREY RD
Practice Address - Street 2:STE. B
Practice Address - City:LAKE CITY
Practice Address - State:MI
Practice Address - Zip Code:49651-8670
Practice Address - Country:US
Practice Address - Phone:517-673-0553
Practice Address - Fax:231-295-1096
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007233101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor