Individual provider · Type 1 NPI

Kimberly Lynn Clicquennoi, LCMHC

Mental Health Counselor · Roxboro, NC

NPI number 1457515157 Active

Practice location

355 S Madison Blvd, Suite C2
Roxboro, NC 27573-5485

Fax (336) 597-2116

Mailing address

3210 Fairhill Dr
Raleigh, NC 27612-3215

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X7108 (NC)

Mental Health Counselor: Definition to come...

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About NPI 1457515157

Kimberly Lynn Clicquennoi, LCMHC's National Provider Identifier is 1457515157, issued on Jul 11, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Roxboro, NC. The record was last updated on Dec 30, 2025.