DR. MARILYN CECELIA KIMBLE (NPI# 1962412601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962412601 |
| Entity Type | Individual |
| Full Name | DR. MARILYN CECELIA KIMBLE |
| Credential | PH.D. |
| Practice Address |
1138 Melrose Dr Clarkston GA 30021-2837 |
| Practice Telephone | 4045082348 |
| Mailing Telephone | 4045082348 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1456 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | EVERCARE CHOICE PROVIDER | 61-00158 | 01 |
| Street Address |
1138 MELROSE DR |
| City | CLARKSTON |
| State | GA |
| Zip Code | 30021-2837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578081808 | Marqueta A Coffer | Case Manager/Care Coordinator | 1380 Brockett Pl, Clarkston, GA 30021 | 2017-09-07 |
| 1063965143 | Bertukan Worku Demas | Pharmacist | 3671 Cobble Mill Ln, Clarkston, GA 30021 | 2016-07-26 |
| 1912341967 | Esther Kim | Family Medicine | 887 N Indian Creek Dr Ste A, Clarkston, GA 30021 | 2013-04-22 |
| 1265739437 | Carepoint Home Care, LLC | In Home Supportive Care | 4122 E Ponce Deleon Avenue, Unit 9, Clarkston, GA 30021 | 2011-02-23 |
| 1790956530 | Thu D. Vu | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| 1740310630 | Gentle Dental | Dentist | 3595 Hill St., Clarkston, GA 30021 | 2007-03-07 |
| 1679528491 | Ojoru Osunkoya | Pediatrics | 4112 E. Ponce De Leon, Clarkston, GA 30021 | 2006-05-23 |
| 1700849825 | Regina Allen Hardin | Pediatrics | 4112 E. Ponce De Leon Avenue, Clarkston, GA 30021 | 2006-04-10 |
| 1831514538 | Caudelle & Wilson Eye Care LLC | Optometrist | 320 N Jeff Davis Drive, Suite A, Fayetteville, GA 30021 | 2014-03-04 |
| 1881865624 | Vanessa Phan | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| Find all providers in zip 30021 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780146720 | Jessica Leigh Teeples | Psychologist | 6060 Dixie Hwy Ste H, Clarkston, MI 48346-3476 | 2019-04-01 |
| 1548569049 | Adam R Pasciak | Psychologist | 3604 Clarkston Rd, Clarkston, MI 48348-5215 | 2011-03-23 |
| 1447559513 | Kelli Lynn Shaheen | Psychologist | 5701 Bow Pointe Dr Ste 380, Clarkston, MI 48346-5406 | 2011-03-15 |
| 1336269158 | Richard W Brozovich | Psychologist | 7127 Perry Lake Rd, Clarkston, MI 48346-1655 | 2007-03-29 |
| 1477690576 | Jarod John Fitzgerald | Psychologist | 629 6th St, Clarkston, WA 99403-2010 | 2007-01-30 |
| 1578587374 | M. Lynn Chambers | Psychologist | 3918 S Ortonville Rd, Suite E, Clarkston, MI 48348-1256 | 2006-07-26 |
| 1376524835 | Joseph Scott Allen Jr. | Psychologist | 7736 Ortonville Rd Ste A, Clarkston, MI 48348-4483 | 2005-11-10 |
| 1124633755 | Gianna Petz | Psychologist | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-09-10 |
| 1881225092 | Nikita Bhatnagar | Psychologist | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2020-01-28 |
| 1194215970 | Ava Elizabeth Selke | Psychologist | 6549 Town Center Dr Ste A, Clarkston, MI 48346-4824 | 2018-05-16 |
| Find all providers in CLARKSTON | ||||
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| 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.