Provider Demographics
NPI:1174132021
Name:GADA-STEINAUER, KIMBERLEY IRENE (LCMHCA)
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:IRENE
Last Name:GADA-STEINAUER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 TRIMBLESTONE LN APT 303
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5976
Mailing Address - Country:US
Mailing Address - Phone:704-677-6849
Mailing Address - Fax:
Practice Address - Street 1:4913 PROFESSIONAL CT STE 207
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-1926
Practice Address - Country:US
Practice Address - Phone:919-333-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15624101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health