Provider Demographics
NPI:1043927429
Name:REED-HARTLEY, KIM (LPC)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:
Last Name:REED-HARTLEY
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 1:9626 CHEAT MOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2073
Mailing Address - Country:US
Mailing Address - Phone:281-745-7407
Mailing Address - Fax:
Practice Address - Street 1:9626 CHEAT MOUNTAIN CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2073
Practice Address - Country:US
Practice Address - Phone:281-745-7407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83875101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty