Provider Demographics
NPI:1407197080
Name:SOBER, KIMBERLY D (LPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:SOBER
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 1:142 COUNTY ROAD 37
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75706-7028
Mailing Address - Country:US
Mailing Address - Phone:903-705-3222
Mailing Address - Fax:
Practice Address - Street 1:142 COUNTY ROAD 37
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75706-7028
Practice Address - Country:US
Practice Address - Phone:903-705-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67133101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional