Provider Demographics
NPI:1215235775
Name:CHRISTIAN, KIMBERLY D (LCSW, BCFBCC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:D
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:LCSW, BCFBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 PHOENIX DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4036
Mailing Address - Country:US
Mailing Address - Phone:469-223-3858
Mailing Address - Fax:
Practice Address - Street 1:16800 DALLAS PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1907
Practice Address - Country:US
Practice Address - Phone:469-223-3858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health