Basic Information
| Provider Information | |||||||||
| NPI: | 1699281832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOWNES | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | ALEXANDER | ||||||||
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| Credential: | CSAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2212 HOPE MILLS RD | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283044228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107790454 | ||||||||
| FaxNumber: | 9104910833 | ||||||||
| Practice Location | |||||||||
| Address1: | 2212 HOPE MILLS RD | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283044228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107790454 | ||||||||
| FaxNumber: | 9104910833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2017 | ||||||||
| LastUpdateDate: | 12/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CSAC-24237 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.