Provider Demographics
NPI:1972215416
Name:HIBBITTS, KIMBERLY LOUISE (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LOUISE
Last Name:HIBBITTS
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 AUBURN ST APT 719
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-1624
Mailing Address - Country:US
Mailing Address - Phone:806-283-6515
Mailing Address - Fax:
Practice Address - Street 1:5205 AUBURN ST APT 719
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-1624
Practice Address - Country:US
Practice Address - Phone:806-283-6515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15145101YA0400X
TX81232101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)