Provider Demographics
NPI:1952099384
Name:SAPP, KIM MARIA (LPC)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:MARIA
Last Name:SAPP
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 1:3436 THAMES PL
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-7173
Mailing Address - Country:US
Mailing Address - Phone:706-877-6472
Mailing Address - Fax:
Practice Address - Street 1:3436 THAMES PL
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-7173
Practice Address - Country:US
Practice Address - Phone:706-877-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010959101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional