Provider Demographics
NPI:1487001293
Name:WOODARD, CAROL LYNN (LPC INTERN, NCC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LYNN
Last Name:WOODARD
Suffix:
Gender:F
Credentials:LPC INTERN, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 W LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-2820
Mailing Address - Country:US
Mailing Address - Phone:214-390-5800
Mailing Address - Fax:
Practice Address - Street 1:4240 W LOVERS LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-2820
Practice Address - Country:US
Practice Address - Phone:214-390-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-22
Last Update Date:2016-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74943101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)