KIMBERLY ODOM (NPI# 1396140331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396140331 |
Entity Type | Individual |
Full Name | KIMBERLY ODOM |
Credential | LPC |
Practice Address |
1630 Vinson Hwy Se Milledgeville GA 31061-4102 |
Mailing Address |
Po Box 213 Milledgeville GA 31059-0213 |
Practice Telephone | 4782519345 |
Mailing Telephone | 4782519345 |
Enumeration Date | 2014-11-04 |
Last Update Date | 2014-11-04 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
007734 | GA | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073083564 | Kimberly Odom | Specialist/Technologist | 2602 White Rose Dr, Loganville, GA 30052-2196 | 2018-11-28 |
1194225722 | Kimberly L Odom | Licensed Vocational Nurse | 680 W Sam Houston Pkwy S Apt 2414, Houston, TX 77042-1570 | 2018-02-20 |
1558901777 | Kimberly Odom | Behavior Technician | 12015 E 46th Ave Ste 680, Denver, CO 80239-3158 | 2020-01-15 |
1386623908 | Kimberly P Odom | Pediatrics | 613 So. Myrtle Avenue, Clearwater, FL 33756 | 2006-01-12 |
Street Address |
1630 VINSON HWY SE |
City | MILLEDGEVILLE |
State | GA |
Zip Code | 31061-4102 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861007403 | Caring Clinic LLC | Nurse Practitioner | 114 Wrights Dr, Milledgeville, GA 31061 | 2020-09-10 |
1629619945 | Gini M Ellis | Counselor | Blandy Way Office Park 60, Highway 22 West, Milledgeville, GA 31061 | 2019-10-08 |
1356992275 | Community Health Care Systems, Inc | Clinic/Center | 100 N Abc Street, Milledgeville, GA 31061 | 2019-09-23 |
1467923805 | Adam Tocio | Specialist/Technologist | 350 W. Washington St., Milledgeville, GA 31061 | 2018-12-11 |
1487170304 | Aubrey Martin | Specialist/Technologist | 251 S Clark St., Milledgeville, GA 31061 | 2017-08-22 |
1427573054 | Heritagefirst Home Care Inc. | In Home Supportive Care | 1277 Twin Pine Road, Milledgeville, GA 31061 | 2017-08-04 |
1851813893 | Brittany Shantrel Primas | Nurse Practitioner | 102 A Airport Road Ne, Milledgeville, GA 31061 | 2017-07-12 |
1609300839 | Samantha Weldon | Behavioral Analyst | 174 Stewart Dr Nw, Milledgeville, GA 31061 | 2017-04-14 |
1427425230 | Foster Deariso | Specialist/Technologist | 251 S Clarke St, Milledgeville, GA 31061 | 2015-08-27 |
1023406279 | Llewelyn Garillos | Occupational Therapist | 3789 Sinclair Dam Road Ne, Milledgeville, GA 31061 | 2014-12-22 |
Find all providers in zip 31061 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174120851 | Helen Jackson | Counselor | 326 Stoneridge Dr Nw, Milledgeville, GA 31061-5453 | 2020-10-05 |
1194369660 | Angelika Johnson | Counselor | 110 Valentine Rd Ne, Milledgeville, GA 31061-8855 | 2019-10-29 |
1629619945 | Gini M Ellis | Counselor | Blandy Way Office Park 60, Highway 22 West, Milledgeville, GA 31061 | 2019-10-08 |
1891286308 | Elizabeth Walters | Counselor | 270 Whistle Way Unit H, Milledgeville, GA 31061-0618 | 2018-05-21 |
1346617842 | Tameka Mack | Counselor | 611 N Wayne St, Milledgeville, GA 31061-2834 | 2015-08-31 |
1902201502 | Ida Freeman | Counselor | 1776 N. Jefferson St. -suite B, Milledgeville, GA 31061 | 2014-10-27 |
1356604979 | Doris Comer Thompson | Counselor | Park 60 Highway 22 West, Milledgeville, GA 31061 | 2012-06-19 |
1861622904 | Amanda H Robinson | Counselor | 22 West Hwy 60 Blanding Way Office Park, Milledgeville, GA 31061-3292 | 2009-07-23 |
1689810913 | Jack Barney Taylor IIi | Counselor | 1617 Flat Shoals Rd Ne, Milledgeville, GA 31061-2203 | 2008-12-16 |
1891903746 | Tracey Leigh Byram | Counselor | 717 Matheson Drive, Milledgeville, GA 31061-2339 | 2007-05-21 |
Find all providers in MILLEDGEVILLE |
City | MILLEDGEVILLE |
Zip Code | 31061 |
Please comment or provide details below to improve the information on KIMBERLY ODOM.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.