1740644004 NPI number — MRS. KIMBERLY BROOKE SCHEIDEGGER LPC, MSHP

Table of content: MRS. KIMBERLY BROOKE SCHEIDEGGER LPC, MSHP (NPI 1740644004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740644004 NPI number — MRS. KIMBERLY BROOKE SCHEIDEGGER LPC, MSHP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHEIDEGGER
Provider First Name:
KIMBERLY
Provider Middle Name:
BROOKE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, MSHP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARMS
Provider Other First Name:
KIMBERLY
Provider Other Middle Name:
BROOKE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740644004
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9045 FOREST CENTRE WAY
Provider Second Line Business Mailing Address:
HEARTLIFE PROFESSIONAL SOUL CARE
Provider Business Mailing Address City Name:
GERMANTOWN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-756-5788
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9045 FOREST CENTRE WAY
Provider Second Line Business Practice Location Address:
HEARTLIFE PROFESSIONAL SOUL CARE
Provider Business Practice Location Address City Name:
GERMANTOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-756-5788
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/12/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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