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General NPI Number Information
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NPI Number | 1841841699
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Entity Type | Individual
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Provider Name | SHAULEA REJEEN KIMMEL LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 363 N SAM HOUSTON PKWY E STE 1100
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City | HOUSTON
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State | TX
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Zip | 77060-2413
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Country | US
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Telephone | 713-715-5001
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Fax | 713-715-5085
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Provider Business Mailing Address
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Address Line | 9802 DUGAS DR
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City | SAN ANTONIO
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State | TX
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Zip | 78245-1052
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Country | US
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Telephone | 210-618-4896
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 62186
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 62186
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License Number State | TX
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