MS. KIMBERLY W MODISETTE (NPI# 1841528114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841528114 |
| Entity Type | Individual |
| Full Name | MS. KIMBERLY W MODISETTE |
| Credential | LPC |
| Practice Address |
120 David Wade Drive Victoria TX 77905 |
| Mailing Address |
P.o. Box 2666 Victoria TX 77902-2666 |
| Practice Telephone | 3615758271 |
| Practice Fax Number | 3615756520 |
| Mailing Telephone | 3615758271 |
| Mailing Fax Number | 3615756520 |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2010-02-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
65881 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 65881 | 05 | |
| TX | 207574901 | 05 |
| Street Address |
120 DAVID WADE DRIVE |
| City | VICTORIA |
| State | TX |
| Zip Code | 77905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609958628 | Devereux Foundation | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2006-10-19 |
| 1447819958 | Amber Fay Kotzur | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2019-06-08 |
| 1053603712 | Scarlett Black | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2011-05-12 |
| 1447572953 | Angelle T Solano | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2010-02-25 |
| 1821232117 | Alyce Yvonne Martin | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2009-04-30 |
| 1073781712 | Elizabeth Edith Stolte | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2008-02-15 |
| 1740407386 | Darlyn R Sustaita | Counselor | 120 David Wade Drive, Victoria, TX 77902-2666 | 2007-04-18 |
| 1982821534 | Jill E Latonick-flores | Counselor | 120 David Wade Drive, Victoria, TX 77902-2666 | 2007-04-18 |
| 1215153838 | Sarah D Sims | Counselor | 120 David Wade Drive, Victoria, TX 77902-2666 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467920116 | Cameo Lynn Mead | Counselor | 513 Dove Dr, Victoria, TX 77905 | 2018-11-09 |
| 1952883308 | Danielle Renee Rainosek | Registered Nurse | 2058 Berger Road, Victoria, TN 77905 | 2018-09-02 |
| 1487130175 | Stephanie Reichert-garza | Licensed Vocational Nurse | 135 Tilley Ln, Victoria, TX 77905 | 2018-07-16 |
| 1417281858 | Debbie A Coltman | Counselor | 120 David Wade Dr, Victoria, TX 77905 | 2009-10-01 |
| 1780186940 | Brooke Salazar | Registered Nurse | 304 Royal Oak St, Victoria, TX 77905-0625 | 2018-03-05 |
| 1336524974 | Adan Hinojosa Adame | Nurse Practitioner | 102 Contento St, Victoria, TX 77905-0688 | 2015-07-24 |
| 1528568383 | Betty Sue Stafford | Licensed Vocational Nurse | 488 Old Bloomington Rd N, Victoria, TX 77905-2118 | 2018-02-19 |
| 1700387008 | Sayra Joyce Borden | Licensed Vocational Nurse | 376 Old Bloomington Rd N, Victoria, TX 77905-2122 | 2018-02-22 |
| 1306478177 | Elizabeth Thompson | Licensed Vocational Nurse | 456 Price Rd, Victoria, TX 77905-2522 | 2020-02-10 |
| 1235610791 | Brenda Ann Kelsey | Registered Nurse | 103 Forest View Dr, Victoria, TX 77905-2565 | 2018-08-23 |
| Find all providers in zip 77905 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952968901 | Eliza Welder | Counselor | 6502 Nursery Dr. Suite, Suite 100, Victoria, TX 77904 | 2019-05-24 |
| 1467920116 | Cameo Lynn Mead | Counselor | 513 Dove Dr, Victoria, TX 77905 | 2018-11-09 |
| 1962941997 | Jacob Weishuhn | Counselor | 4702 N Laurent St Ste D, Victoria, TX 77904-2158 | 2017-02-23 |
| 1740724939 | Sarah Ritchea | Counselor | 6502 Nursery Dr. Suite 100, Victoria, TX 77904 | 2016-12-07 |
| 1992156244 | Ruby Lenamon | Counselor | 120 David Wade, Victoria, TX 77905-4404 | 2016-06-28 |
| 1457714396 | Otilia Chavez | Counselor | 1801 N Laurent St Ste 107, Victoria, TX 77901-5462 | 2016-03-29 |
| 1235591140 | Mark Fitzsimmons | Counselor | 204 Nantucket Ave, Victoria, TX 77904-2504 | 2016-03-22 |
| 1659731859 | Josephine Elizabeth Kee-rees | Counselor | 1501 E. Mockingbird Ln., Suite #275, Victoria, TX 77904-2189 | 2016-03-01 |
| 1962848952 | Magdalene Mata | Counselor | 117 Brookwood, Victoria, TX 77901-3820 | 2013-05-16 |
| 1215288295 | Linda L Autry | Counselor | 104 Kelly Dr Ste D, Victoria, TX 77904-1551 | 2012-10-01 |
| Find all providers in VICTORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.