Provider Demographics
NPI:1245460286
Name:UPRIGHT, KIM (LPC)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:UPRIGHT
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 1:1105 WOODED ACRES DR
Mailing Address - Street 2:SUITE #270
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4468
Mailing Address - Country:US
Mailing Address - Phone:254-751-1164
Mailing Address - Fax:254-751-1736
Practice Address - Street 1:1105 WOODED ACRES DR
Practice Address - Street 2:SUITE #270
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4468
Practice Address - Country:US
Practice Address - Phone:254-751-1164
Practice Address - Fax:254-751-1736
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63675101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional