Provider Demographics
NPI:1467126698
Name:KIMBERLY ROWBOTHAM COUNSELING LLC
Entity type:Organization
Organization Name:KIMBERLY ROWBOTHAM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST, MANAGER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWBOTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSLPC-MH, NCC, QMHP
Authorized Official - Phone:605-203-2041
Mailing Address - Street 1:4109 S CARNEGIE CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2321
Mailing Address - Country:US
Mailing Address - Phone:605-610-8698
Mailing Address - Fax:
Practice Address - Street 1:4109 S CARNEGIE CIR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2321
Practice Address - Country:US
Practice Address - Phone:605-610-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-02
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)