Provider Demographics
NPI:1700111317
Name:CARTER SCHMITTOU, KIMBERLY (NCC LPC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:CARTER SCHMITTOU
Suffix:
Gender:F
Credentials:NCC LPC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:CARTER
Other - Last Name:PAREDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3110 BLANCO PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3401
Mailing Address - Country:US
Mailing Address - Phone:210-478-2987
Mailing Address - Fax:
Practice Address - Street 1:211 N PARK BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78204-2431
Practice Address - Country:US
Practice Address - Phone:210-478-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10539101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional