Provider Demographics
NPI:1790008514
Name:NIMMONS, KIMBERLY ANN HALMAN (LCPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN HALMAN
Last Name:NIMMONS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11354 CHERRY HILL RD
Mailing Address - Street 2:#201
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3747
Mailing Address - Country:US
Mailing Address - Phone:240-460-2950
Mailing Address - Fax:
Practice Address - Street 1:1102 FOREST GLEN RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-2101
Practice Address - Country:US
Practice Address - Phone:301-593-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3451101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional