Healthcare Provider Details

I. General information

NPI: 1851855043
Provider Name (Legal Business Name): LAKITRIA LIMBRICK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W GIBSON ST STE 100
JASPER TX
75951-4970
US

IV. Provider business mailing address

PO BOX 388
JASPER TX
75951-0005
US

V. Phone/Fax

Practice location:
  • Phone: 877-814-1782
  • Fax: 877-671-0786
Mailing address:
  • Phone: 877-814-1782
  • Fax: 833-671-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6836
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6836
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number85112
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number85112
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: