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General NPI Number Information
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NPI Number | 1932544590
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Entity Type | Individual
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Provider Name | KIRBY K. REUTTER PHD, MSCP, LMHC
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Gender | Male
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 136 CLEAR WATER PASS
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City | BASTROP
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State | TX
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Zip | 78602-2434
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Country | US
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Telephone | 512-788-5611
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Fax | 512-456-8124
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Provider Business Mailing Address
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Address Line | 136 CLEAR WATER PASS
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City | BASTROP
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State | TX
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Zip | 78602-2434
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Country | US
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Telephone | 512-788-5611
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Fax | 512-456-8124
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 37448
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7158
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License Number State | OH
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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 | 39002367A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.010833
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License Number State | IL
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