Provider Demographics
NPI:1669013413
Name:FLEISCHER, KIMBERLY (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:FLEISCHER
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 1:110 E HIGHWAY 82
Mailing Address - Street 2:
Mailing Address - City:NOCONA
Mailing Address - State:TX
Mailing Address - Zip Code:76255-2721
Mailing Address - Country:US
Mailing Address - Phone:469-556-3837
Mailing Address - Fax:
Practice Address - Street 1:190 E RUSSELL ST
Practice Address - Street 2:
Practice Address - City:RHOME
Practice Address - State:TX
Practice Address - Zip Code:76078-4487
Practice Address - Country:US
Practice Address - Phone:817-592-9248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75581101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional