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Ms. Kimberly Sue Wasoski, LMHC,LCAC
Mental Health Counselor in South Bend, Indiana
NPI 1639358161

Kimberly Sue Wasoski is a Mental Health Counselor based in South Bend, IN and is specialized in Mental Health. Kimberly Sue Wasoski practices in South Bend, IN and has the professional credentials of LMHC,LCAC. The NPI Number for Kimberly Sue Wasoski is 1639358161 and holds a License No. 39000873A (Indiana).

The current practice location address for Kimberly Sue Wasoski is 3220 E Jefferson Blvd, South Bend, IN and can be reached out via phone at 574-222-2466 and via fax at 574-222-2468. You can also correspond with Kimberly Sue Wasoski through the mailing address at 3220 E. JEFFERSON BLVD., SOUTH BEND, IN - 46615-2733 (mailing address contact number: 574-222-2466).

Location: 3220 E Jefferson Blvd, South Bend, IN, 46615-2733
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Provider Profile Details
NPI Number
1639358161
Provider Name
Kimberly Sue Wasoski
Credential
LMHC,LCAC
Provider Entity Type
Individual
Gender
Female
Address
3220 E Jefferson Blvd, South Bend, IN, 46615-2733
Phone Number
574-222-2466
Fax Number
574-222-2468
Provider Enumeration Date
11/01/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000542441 01 IN UNICARE
200375890A 05 IN
000000542441 01 IN ANTHEM
institution
Provider Business Practice Location Address Details
Address
3220 E Jefferson Blvd
City
State
Zip
46615-3028
Phone Number
574-222-2466
Fax Number
574-222-2468
person
Provider Business Mailing Address Details
Address
3220 E Jefferson Blvd
City
State
Zip
46615-3028
Phone Number
574-222-2466
Fax Number
574-222-2468
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
39000873A (Indiana)
Definition
Definition to come...
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