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Individual

MR. JEFFREY ALLAN KIMEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, CSAC, ICS

Contact information

Practice address
16 N CARROLL ST, SUITE 400, MADISON, WI 53703-2716
(262) 898-2940
Mailing address
16 N CARROLL ST STE 400, MADISON, WI 53703-2762
(608) 514-1672

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16013-132
WI
101YP2500X
Professional Counselor
1996 - 226
WI
101YP2500X
Professional Counselor
Primary
5797-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100095265
WI
Enumeration date
12/08/2013
Last updated
06/09/2021
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