Individual
KIMBERLY MONDEZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CSAC, CRC
Contact information
Practice address
7008 MAPLE LEAF LN, PRINCE GEORGE, VA 23875-2669
(804) 439-0871
Mailing address
7008 MAPLE LEAF LN, PRINCE GEORGE, VA 23875-2669
(804) 601-4603
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102851
VA
101YP2500X
Professional Counselor
Primary
0701006952
VA
225C00000X
Rehabilitation Counselor
00117448
VA
Other
Enumeration date
12/06/2017
Last updated
03/12/2025
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