Provider Demographics
NPI:1235586793
Name:NESMITH, KIMBERLEY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:NESMITH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 MAPLE SHADE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8587
Mailing Address - Country:US
Mailing Address - Phone:254-366-2582
Mailing Address - Fax:254-235-1104
Practice Address - Street 1:110 MIDWAY CTR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3637
Practice Address - Country:US
Practice Address - Phone:254-366-2582
Practice Address - Fax:254-235-1104
Is Sole Proprietor?:No
Enumeration Date:2016-05-14
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health