Provider Demographics
NPI:1184750077
Name:MCKIBBEN, KAREN KAY (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:KAY
Last Name:MCKIBBEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2246 BISSONNET ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1510
Mailing Address - Country:US
Mailing Address - Phone:713-529-7400
Mailing Address - Fax:713-630-0934
Practice Address - Street 1:2246 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1510
Practice Address - Country:US
Practice Address - Phone:713-529-7400
Practice Address - Fax:713-630-0934
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17640385101YA0400X
TX147191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical