Provider Demographics
NPI:1205323920
Name:KIMBLE, JEANNE TERESA (LMHC)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:TERESA
Last Name:KIMBLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4726 43RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1803
Mailing Address - Country:US
Mailing Address - Phone:206-227-9600
Mailing Address - Fax:
Practice Address - Street 1:4726 43RD AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1803
Practice Address - Country:US
Practice Address - Phone:206-227-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60581541101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health