Individual
KIMBERLEY PAVLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC, LCAS
Contact information
Practice address
1513 REYNOLDS MILL RD, WAKE FOREST, NC 27587-5613
(984) 230-9687
Mailing address
8362 SIX FORKS RD STE 102, RALEIGH, NC 27615-5086
(984) 230-9687
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
25270
NC
101YP2500X
Professional Counselor
Primary
13749
NC
Other
Enumeration date
08/24/2018
Last updated
10/01/2023
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