Provider Demographics
NPI:1437282688
Name:MEHLOMAKULU, CAROLYN BENENE (LMFT-S, ATR)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:BENENE
Last Name:MEHLOMAKULU
Suffix:
Gender:F
Credentials:LMFT-S, ATR
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:BENENE
Other - Last Name:STALZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13706 RESEARCH BLVD, STE. 114
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750
Mailing Address - Country:US
Mailing Address - Phone:512-660-7279
Mailing Address - Fax:512-233-5944
Practice Address - Street 1:13706 RESEARCH BLVD, STE. 114
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750
Practice Address - Country:US
Practice Address - Phone:512-660-7279
Practice Address - Fax:512-233-5944
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201229106H00000X
CAMFC 51426106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist