Individual
MR. DEREK K KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LMFT
Contact information
Practice address
205 S PARK LN, ALTUS, OK 73521-5755
(580) 379-6850
(580) 379-6859
Mailing address
PO BOX 8190, ALTUS, OK 73522-8190
(580) 379-5150
(580) 379-5159
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1365
OK
106H00000X
Marriage & Family Therapist
1131
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200270420A
—
OK
Enumeration date
07/28/2006
Last updated
01/02/2024
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