Provider Demographics
NPI:1588156079
Name:NDOMAHINA, REUBEN KINIE (MS, LPC-S)
Entity type:Individual
Prefix:MR
First Name:REUBEN
Middle Name:KINIE
Last Name:NDOMAHINA
Suffix:
Gender:M
Credentials:MS, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 ALMA DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3568
Mailing Address - Country:US
Mailing Address - Phone:972-422-5939
Mailing Address - Fax:
Practice Address - Street 1:7308 ALMA DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3568
Practice Address - Country:US
Practice Address - Phone:972-422-5939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72803101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health