Provider Demographics
NPI:1902147697
Name:HOUSE, KIMBERLY DAWN (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DAWN
Last Name:HOUSE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 VIRGINIA PKWY
Mailing Address - Street 2:SUITE #108
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5084
Mailing Address - Country:US
Mailing Address - Phone:972-542-8144
Mailing Address - Fax:
Practice Address - Street 1:2750 VIRGINIA PKWY
Practice Address - Street 2:SUITE #108
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5084
Practice Address - Country:US
Practice Address - Phone:972-542-8144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16604101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional