Provider Demographics
NPI:1437227410
Name:HARRISON, CAROLYN S (LPC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:S
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:S
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:52 GAZEBO ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-2205
Mailing Address - Country:US
Mailing Address - Phone:936-661-4775
Mailing Address - Fax:
Practice Address - Street 1:26515 OAK RIDGE DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1966
Practice Address - Country:US
Practice Address - Phone:281-367-0328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16853101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional