Provider Demographics
NPI:1346847761
Name:FOX, KIMBERLY PATRICE (LPC, RPT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:PATRICE
Last Name:FOX
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17890 BLANCO RD STE 307
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1098
Mailing Address - Country:US
Mailing Address - Phone:210-314-2026
Mailing Address - Fax:
Practice Address - Street 1:17890 BLANCO RD STE 307
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1098
Practice Address - Country:US
Practice Address - Phone:210-314-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80278101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health