Provider Demographics
NPI:1033704143
Name:GASKILL, KIMBERLEY KAY (EDD, LPC, CSC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLEY
Middle Name:KAY
Last Name:GASKILL
Suffix:
Gender:F
Credentials:EDD, LPC, CSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 GENTILZ ST
Mailing Address - Street 2:
Mailing Address - City:CASTROVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78009-4059
Mailing Address - Country:US
Mailing Address - Phone:210-241-5423
Mailing Address - Fax:
Practice Address - Street 1:812 GENTILZ ST
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:TX
Practice Address - Zip Code:78009-4059
Practice Address - Country:US
Practice Address - Phone:210-241-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72272101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor