Provider Demographics
NPI:1801143417
Name:SCHOCKET, KIMBERLY (PHD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:SCHOCKET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 SHOAL CREEK BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-8051
Mailing Address - Country:US
Mailing Address - Phone:512-467-7246
Mailing Address - Fax:512-467-7247
Practice Address - Street 1:3508 FAR WEST BLVD STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-2290
Practice Address - Country:US
Practice Address - Phone:512-467-7246
Practice Address - Fax:512-467-7247
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34474103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical