Provider Demographics
NPI:1649693979
Name:WRIGHT, KIMBERLY MICHELLE (MS, LMHC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MICHELLE
Last Name:WRIGHT
Suffix:
Gender:
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5092 TAYLOR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-1121
Mailing Address - Country:US
Mailing Address - Phone:904-635-5330
Mailing Address - Fax:904-862-6767
Practice Address - Street 1:5092 TAYLOR CREEK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-1121
Practice Address - Country:US
Practice Address - Phone:904-635-5330
Practice Address - Fax:904-862-6767
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13987101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health