Provider Demographics
NPI:1871755546
Name:EARLES HINSON, KIMBERLY (LPC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:EARLES HINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:E
Other - Last Name:HINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2099 DUPRE ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-2311
Mailing Address - Country:US
Mailing Address - Phone:985-674-9046
Mailing Address - Fax:985-674-2391
Practice Address - Street 1:2099 DUPRE ST
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-2311
Practice Address - Country:US
Practice Address - Phone:985-674-9046
Practice Address - Fax:985-674-2391
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3210101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health