Provider Demographics
NPI:1114723111
Name:MALONE, KIMBERLIE-VERITY (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLIE-VERITY
Middle Name:
Last Name:MALONE
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 1:3708 E 29TH ST # 1026
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3901
Mailing Address - Country:US
Mailing Address - Phone:979-484-5111
Mailing Address - Fax:
Practice Address - Street 1:3708 E 29TH ST # 1026
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3901
Practice Address - Country:US
Practice Address - Phone:979-484-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90281101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional