Provider Demographics
NPI:1265083844
Name:HOPPERS, KIM (LPC)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:
Last Name:HOPPERS
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 1:1601 MEDICAL CENTER DR STE 9
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6359
Mailing Address - Country:US
Mailing Address - Phone:405-305-5319
Mailing Address - Fax:
Practice Address - Street 1:1601 MEDICAL CENTER DR STE 9
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6359
Practice Address - Country:US
Practice Address - Phone:405-305-5319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10121101Y00000X, 101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor