Provider Demographics
NPI:1992283956
Name:MCCLURKAN, KIMBERLY KAY (LPC)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:KAY
Last Name:MCCLURKAN
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 1:9323 MANCHACA RD APT 426
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6246
Mailing Address - Country:US
Mailing Address - Phone:512-961-3115
Mailing Address - Fax:
Practice Address - Street 1:9323 MANCHACA RD APT 426
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6246
Practice Address - Country:US
Practice Address - Phone:512-961-3115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health