Provider Demographics
NPI:1669641320
Name:CARTER, KATHRYN LEE (LPC, MA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEE
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:BRIGGS
Mailing Address - State:TX
Mailing Address - Zip Code:78608-0056
Mailing Address - Country:US
Mailing Address - Phone:512-925-5231
Mailing Address - Fax:
Practice Address - Street 1:2304 HANCOCK DR STE 7C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2543
Practice Address - Country:US
Practice Address - Phone:512-925-5231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59760101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health