Provider Demographics
NPI:1669113072
Name:MOORHEAD, KIMBERLY (PSYD, LMFT ASSOCIATE)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:MOORHEAD
Suffix:
Gender:
Credentials:PSYD, LMFT ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4175 E AMAZON DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4660
Mailing Address - Country:US
Mailing Address - Phone:541-600-4441
Mailing Address - Fax:
Practice Address - Street 1:4175 E AMAZON DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4660
Practice Address - Country:US
Practice Address - Phone:541-600-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR6696390200000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program