Provider Demographics
NPI:1023495322
Name:RIMSKY, DEIDRA (LPC)
Entity type:Individual
Prefix:
First Name:DEIDRA
Middle Name:
Last Name:RIMSKY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEIDRA
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 661
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:TX
Mailing Address - Zip Code:75760-0661
Mailing Address - Country:US
Mailing Address - Phone:369-465-7732
Mailing Address - Fax:
Practice Address - Street 1:283 S 6TH ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:TX
Practice Address - Zip Code:75760-2905
Practice Address - Country:US
Practice Address - Phone:936-465-7732
Practice Address - Fax:936-633-5695
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64279101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health