Provider Demographics
NPI:1902301443
Name:SUMMERHAYS, KIMBERLY ANNE (LPC, QMHP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:SUMMERHAYS
Suffix:
Gender:F
Credentials:LPC, QMHP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:SUMMERHAYS-MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICENSED PROFESSIONA
Mailing Address - Street 1:2580 AUGUSTA ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-2217
Mailing Address - Country:US
Mailing Address - Phone:541-501-2685
Mailing Address - Fax:
Practice Address - Street 1:1355 OAK ST STE 101
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3566
Practice Address - Country:US
Practice Address - Phone:541-342-8208
Practice Address - Fax:541-242-2200
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional