MEDICARE: KIMBERLY SOTMAN GARRETT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	78735	TX

General Provider Information

NPI Number	:	1447873880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY SOTMAN GARRETT LPC

Provider Business Mailing Address
First Line	:	5900 BALCONES DRIVE
Second Line	:	SUITE 100
City	:	AUSTIN
State	:	TX
Zip	:	78731
Country	:	US
Telephone Number	:	817-761-0871
Fax Number	:

Provider Business Practice Location Address
First Line	:	4104 HARTWOOD DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-1609
Country	:	US
Telephone Number	:	817-761-0871
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	01/06/2025

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