Provider Demographics
NPI:1740668557
Name:BEARD, KIMBERLY JOY (LMSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JOY
Last Name:BEARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-3667
Mailing Address - Country:US
Mailing Address - Phone:214-226-1173
Mailing Address - Fax:
Practice Address - Street 1:3021 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-3667
Practice Address - Country:US
Practice Address - Phone:214-226-1173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010792441041C0700X
TX60821101YP2500X
TX102215101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor