Provider Demographics
NPI:1619382108
Name:MYBURGH, CARIEN (LPC)
Entity Type:Individual
Prefix:MS
First Name:CARIEN
Middle Name:
Last Name:MYBURGH
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 1:8380 WARREN PKWY
Mailing Address - Street 2:STE 201
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4198
Mailing Address - Country:US
Mailing Address - Phone:972-377-2625
Mailing Address - Fax:972-377-2667
Practice Address - Street 1:8380 WARREN PKWY
Practice Address - Street 2:STE 201
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4198
Practice Address - Country:US
Practice Address - Phone:972-377-2625
Practice Address - Fax:972-377-2667
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional