Provider Demographics
NPI:1063183531
Name:KIRKLAND, ARIEL (LPC, LSSP)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:LPC, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 79TH ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8763
Mailing Address - Country:US
Mailing Address - Phone:469-601-4758
Mailing Address - Fax:
Practice Address - Street 1:1003 3RD STREET
Practice Address - Street 2:
Practice Address - City:LORENZO
Practice Address - State:TX
Practice Address - Zip Code:79343
Practice Address - Country:US
Practice Address - Phone:806-634-5591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79810101YP2500X
TX71967103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional