Provider Demographics
NPI:1881239200
Name:RAEF, KIMBER-LEA (LPC, NCC)
Entity type:Individual
Prefix:
First Name:KIMBER-LEA
Middle Name:
Last Name:RAEF
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 CALLAGHAN RD STE 425
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4737
Mailing Address - Country:US
Mailing Address - Phone:210-366-3700
Mailing Address - Fax:210-265-1442
Practice Address - Street 1:5700 SCHERTZ PKWY STE 150
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1497
Practice Address - Country:US
Practice Address - Phone:210-366-3700
Practice Address - Fax:210-265-1442
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health