Provider Demographics
NPI:1073858502
Name:COOPER MURRIEL, CAROLYN ANN (LMFT-A, LCDC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:COOPER MURRIEL
Suffix:
Gender:F
Credentials:LMFT-A, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 QUAIL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-7163
Mailing Address - Country:US
Mailing Address - Phone:469-247-6412
Mailing Address - Fax:
Practice Address - Street 1:2305 RIDGE RD
Practice Address - Street 2:SUITE 101-D
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5162
Practice Address - Country:US
Practice Address - Phone:469-757-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12455101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)