Provider Demographics
NPI:1538614144
Name:MCCAIN, KIMBRLEI (LPC)
Entity type:Individual
Prefix:
First Name:KIMBRLEI
Middle Name:
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 PR 3151 APT 3
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-7017
Mailing Address - Country:US
Mailing Address - Phone:205-965-8390
Mailing Address - Fax:
Practice Address - Street 1:3230 E WOODMEN RD STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8502
Practice Address - Country:US
Practice Address - Phone:719-623-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2637A101Y00000X
CO0018097101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor