Provider Demographics
NPI:1093583239
Name:HOLMES, KIMBERLY TAYLOR (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:TAYLOR
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:DAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3811 BEE CAVES RD STE 204
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6459
Mailing Address - Country:US
Mailing Address - Phone:737-263-0044
Mailing Address - Fax:
Practice Address - Street 1:3811 BEE CAVES RD STE 204
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6459
Practice Address - Country:US
Practice Address - Phone:737-263-0044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical