Provider Demographics
NPI:1649717646
Name:MAHR, KIMBERLY A (MSC, LPC, NCC, CCTP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:A
Last Name:MAHR
Suffix:
Gender:F
Credentials:MSC, LPC, NCC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27311
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0138
Mailing Address - Country:US
Mailing Address - Phone:480-616-2165
Mailing Address - Fax:
Practice Address - Street 1:10149 N 92ND ST STE 103
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4557
Practice Address - Country:US
Practice Address - Phone:480-616-2165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC19429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional