Provider Demographics
NPI:1730476326
Name:PRIESS, KIMBERLY ANN (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANN
Last Name:PRIESS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 N GREENVILLE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8622
Mailing Address - Country:US
Mailing Address - Phone:214-394-5971
Mailing Address - Fax:214-509-6887
Practice Address - Street 1:1506 N GREENVILLE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8622
Practice Address - Country:US
Practice Address - Phone:214-394-5971
Practice Address - Fax:214-509-6887
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64566101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional