Provider Demographics
NPI:1326702747
Name:HASTEY, KIMBERLYN RENEE' (LPC, LSOTP)
Entity Type:Individual
Prefix:
First Name:KIMBERLYN
Middle Name:RENEE'
Last Name:HASTEY
Suffix:
Gender:F
Credentials:LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 COUNTY ROAD 7670
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-9443
Mailing Address - Country:US
Mailing Address - Phone:806-281-8167
Mailing Address - Fax:
Practice Address - Street 1:3009 COUNTY ROAD 7670
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-9443
Practice Address - Country:US
Practice Address - Phone:806-281-8167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70671101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional