Provider Demographics
NPI:1932246527
Name:GOINS, KIMBERLY DIONE (LPC, SAC-IT)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:DIONE
Last Name:GOINS
Suffix:
Gender:F
Credentials:LPC, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3472 N DOUSMAN ST APT A
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1756
Mailing Address - Country:US
Mailing Address - Phone:414-708-3151
Mailing Address - Fax:
Practice Address - Street 1:8200 W SILVER SPRING DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2552
Practice Address - Country:US
Practice Address - Phone:414-372-8080
Practice Address - Fax:414-464-6472
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18306-130101YA0400X
WI3395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty