Provider Demographics
NPI:1114671567
Name:MARINO, CAROL (LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MARINO
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11769 SABINO CT
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-0252
Mailing Address - Country:US
Mailing Address - Phone:214-641-9843
Mailing Address - Fax:
Practice Address - Street 1:2651 SAGEBRUSH DR STE 104
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2727
Practice Address - Country:US
Practice Address - Phone:214-641-9843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87992101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional