Provider Demographics
NPI:1285030155
Name:KIMBERLY A. S PEARS ME, LPC, INC.
Entity Type:Organization
Organization Name:KIMBERLY A. S PEARS ME, LPC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISCENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:405-340-4321
Mailing Address - Street 1:3855 S BOULEVARD
Mailing Address - Street 2:100
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5498
Mailing Address - Country:US
Mailing Address - Phone:405-340-4321
Mailing Address - Fax:
Practice Address - Street 1:3855 S BOULEVARD
Practice Address - Street 2:100
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5498
Practice Address - Country:US
Practice Address - Phone:405-340-4321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5379101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty