Provider Demographics
NPI:1457638751
Name:KINSELLA, KAREN BETH (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:BETH
Last Name:KINSELLA
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9315 CRESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2636
Mailing Address - Country:US
Mailing Address - Phone:214-226-7290
Mailing Address - Fax:
Practice Address - Street 1:9315 CRESTLAKE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2636
Practice Address - Country:US
Practice Address - Phone:214-226-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14511101YM0800X
TX4800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist