Provider Demographics
NPI:1740445535
Name:WILLIAMS, KIMBERLY SUNSHINE (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SUNSHINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 N MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-4439
Mailing Address - Country:US
Mailing Address - Phone:704-480-1882
Mailing Address - Fax:704-480-1832
Practice Address - Street 1:618 N MORGAN ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4439
Practice Address - Country:US
Practice Address - Phone:704-480-1882
Practice Address - Fax:704-480-1832
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103950Medicaid