Provider Demographics
NPI:1902241615
Name:JEAN-CHARLES, KIMYAH M (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KIMYAH
Middle Name:M
Last Name:JEAN-CHARLES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KIMYAH
Other - Middle Name:M
Other - Last Name:SAXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:
Practice Address - Street 1:713 TROY SCHENECTADY RD STE 224
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2490
Practice Address - Country:US
Practice Address - Phone:518-785-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health