Provider Demographics
NPI:1659762748
Name:DR. KIMBERLY JOINER KING COUNSELING, PLLC
Entity Type:Organization
Organization Name:DR. KIMBERLY JOINER KING COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:940-595-3219
Mailing Address - Street 1:1395 ARBUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1415
Mailing Address - Country:US
Mailing Address - Phone:940-595-3219
Mailing Address - Fax:
Practice Address - Street 1:5200 MCDERMOTT RD
Practice Address - Street 2:SUITE 230
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7746
Practice Address - Country:US
Practice Address - Phone:940-595-3219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17884101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17884OtherLICENSED PROFESSIONAL COUNSELOR