Provider Demographics
NPI:1528847357
Name:BIRES, KELLY (LPC-A)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:BIRES
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-7407
Mailing Address - Country:US
Mailing Address - Phone:713-822-0385
Mailing Address - Fax:
Practice Address - Street 1:4203 MONTROSE BLVD STE 480
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5474
Practice Address - Country:US
Practice Address - Phone:713-331-5538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor