Provider Demographics
NPI:1932544590
Name:REUTTER, KIRBY K (PHD, MSCP, LMHC)
Entity type:Individual
Prefix:DR
First Name:KIRBY
Middle Name:K
Last Name:REUTTER
Suffix:
Gender:M
Credentials:PHD, MSCP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 CLEAR WATER PASS
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-2434
Mailing Address - Country:US
Mailing Address - Phone:512-788-5611
Mailing Address - Fax:512-456-8124
Practice Address - Street 1:136 CLEAR WATER PASS
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-2434
Practice Address - Country:US
Practice Address - Phone:512-788-5611
Practice Address - Fax:512-456-8124
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37448103TC0700X
OH7158103TC0700X
IN39002367A101YM0800X
IL071.010833103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health