PROF. KIMBERLY KAYE ASNER-SELF (NPI# 1992053771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992053771 |
| Entity Type | Individual |
| Full Name | PROF. KIMBERLY KAYE ASNER-SELF |
| Credential | ED.D., NCC, LCPC |
| Practice Address |
109 Lou Ann Dr Herrin IL 62948-3733 |
| Mailing Address |
625 Wham Dr Mail Code 4618 Carbondale IL 62901-4313 |
| Practice Telephone | 6189881330 |
| Practice Fax Number | 6189888321 |
| Mailing Telephone | 6184532311 |
| Mailing Fax Number | 6184537110 |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2012-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.004440 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSED CLINICAL PROFESSION COUNSELOR | 180.004440 | 01 |
| Street Address |
109 LOU ANN DR |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-3733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508836362 | Lyn E. Flahardy | Social Worker | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-01-25 |
| 1003238106 | Children's Home and Aid | Community/Behavioral Health | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2014-01-09 |
| 1649516691 | Melinda Squires | Social Worker | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2012-12-19 |
| 1336356245 | Robyn S Davis | Social Worker | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2007-05-17 |
| 1164451902 | David E Matthews | Counselor | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-07-02 |
| 1881654358 | Duaine Carlton | Counselor | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-03-27 |
| 1205896784 | David E Matthews | Social Worker | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-03-27 |
| 1821058066 | Stephanie R Gustave | Counselor | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-03-23 |
| 1801856919 | Marcia Malnar | Social Worker | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164451902 | David E Matthews | Counselor | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-07-02 |
| 1881654358 | Duaine Carlton | Counselor | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-03-27 |
| 1821058066 | Stephanie R Gustave | Counselor | 109 Lou Ann Dr, Herrin, IL 62948-3733 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952194 | Hope Kravetz | Counselor | 815 Belinder Ln, Schaumburg, IL 60173-6360 | 2020-11-07 |
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1831798404 | Erin Frasco | Counselor | 622 Davis St # 200, Evanston, IL 60201-4491 | 2020-10-23 |
| 1568061224 | Alternative Counseling Solutions, Inc | Counselor | 6469 E Mccormick Rd, Stillman Valley, IL 61084-9736 | 2020-10-22 |
| 1396344537 | Janet M Wills | Counselor | 223 N Prospect Ave, Streamwood, IL 60107-4103 | 2020-10-19 |
| 1225637614 | Sharice Ellenwood | Counselor | 1087 N Village Dr, Round Lake Beach, IL 60073 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
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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.