Provider Demographics
NPI:1831798776
Name:TAYLOR, KIMBERLY R (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12712 W LAKE HOUSTON PKWY # B-4023
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-6467
Mailing Address - Country:US
Mailing Address - Phone:281-706-4640
Mailing Address - Fax:
Practice Address - Street 1:12712 W LAKE HOUSTON PKWY # B-4023
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-6467
Practice Address - Country:US
Practice Address - Phone:281-706-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty