Provider Demographics
NPI:1538972138
Name:SIMON, KIMBERLY JO (LPCC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JO
Last Name:SIMON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 GRANITE STREET
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56241
Mailing Address - Country:US
Mailing Address - Phone:573-673-9212
Mailing Address - Fax:
Practice Address - Street 1:1010 MARYLAND LN
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-7530
Practice Address - Country:US
Practice Address - Phone:218-736-1800
Practice Address - Fax:218-739-7414
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02380101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health