Provider Demographics
NPI:1952745168
Name:KIMMEL & ASSOC, INC
Entity Type:Organization
Organization Name:KIMMEL & ASSOC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOANALYST
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:206-447-1895
Mailing Address - Street 1:219 1ST AVE S
Mailing Address - Street 2:SUITE 405
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2575
Mailing Address - Country:US
Mailing Address - Phone:206-447-1895
Mailing Address - Fax:
Practice Address - Street 1:219 1ST AVE S
Practice Address - Street 2:SUITE 405
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2575
Practice Address - Country:US
Practice Address - Phone:206-447-1895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00004627101YM0800X
WALF 00000927106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty