Provider Demographics
NPI:1043885783
Name:KINERMON, DIAMOND (ALC)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:
Last Name:KINERMON
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 PENTLAND DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2060
Mailing Address - Country:US
Mailing Address - Phone:131-228-6557
Mailing Address - Fax:
Practice Address - Street 1:3411 PRIMM LN APT G
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-5631
Practice Address - Country:US
Practice Address - Phone:312-286-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL04976101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor