Provider Demographics
NPI:1659893766
Name:LITTERAL, CAROLYN JEAN (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JEAN
Last Name:LITTERAL
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:JEAN
Other - Last Name:BURLESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-S, LCDC
Mailing Address - Street 1:2516 SILVERTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-5866
Mailing Address - Country:US
Mailing Address - Phone:830-357-8933
Mailing Address - Fax:940-240-3096
Practice Address - Street 1:2828 E TRINITY MILLS RD STE 106
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-2327
Practice Address - Country:US
Practice Address - Phone:830-357-8933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75008101YP2500X
TX13108101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13972933OtherCAQH