Provider Demographics
NPI:1962724427
Name:KIRKPATRICK, TERESA (LPC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E US HIGHWAY 80 STE 448
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-8722
Mailing Address - Country:US
Mailing Address - Phone:214-940-5028
Mailing Address - Fax:
Practice Address - Street 1:750 E US HIGHWAY 80 STE 448
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-8722
Practice Address - Country:US
Practice Address - Phone:214-940-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64118101YM0800X, 102L00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst