Provider Demographics
NPI:1588434625
Name:WILMETH, CHRISTY (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:WILMETH
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 1:105 TILFORD AVE
Mailing Address - Street 2:
Mailing Address - City:RALLS
Mailing Address - State:TX
Mailing Address - Zip Code:79357-3415
Mailing Address - Country:US
Mailing Address - Phone:806-777-4558
Mailing Address - Fax:
Practice Address - Street 1:4703 S LOOP 289
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2224
Practice Address - Country:US
Practice Address - Phone:806-687-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional