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General NPI Number Information
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NPI Number | 1841640893
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Entity Type | Individual
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Provider Name | TAMIKA NICOLE MCKINDRA M.S., LPC
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Gender | Female
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 1106 SANTA FE TRL STE 9
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City | DUNCANVILLE
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State | TX
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Zip | 75137-3063
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Country | US
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Telephone | 469-260-4122
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Fax |
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Provider Business Mailing Address
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Address Line | 6114 COBALT ST
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City | HOUSTON
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State | TX
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Zip | 77016-1303
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Country | US
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Telephone | 469-260-4122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 72002
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 72002
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 72002
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License Number State | TX
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