Provider Demographics
NPI:1174666507
Name:JAMES, CAROLINE W (LPC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:W
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5325
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75608-5325
Mailing Address - Country:US
Mailing Address - Phone:903-445-2142
Mailing Address - Fax:903-236-8510
Practice Address - Street 1:108 WAIN DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-1231
Practice Address - Country:US
Practice Address - Phone:903-445-2142
Practice Address - Fax:903-236-8510
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80907LOtherBLUE CROSS BLUE SHIELD
TX095621101Medicaid
TX095621103Medicaid