Provider Demographics
NPI:1760980411
Name:TRAN, KIM (LPC)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:TRAN
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 1:957 NASA PKWY # 511
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3039
Mailing Address - Country:US
Mailing Address - Phone:281-488-0615
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 4000
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:281-488-0615
Practice Address - Fax:281-488-1390
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health