Provider Demographics
NPI:1740613660
Name:WHITMORE, CARYN MELANCON (MS, LPC, NCC, CSC)
Entity Type:Individual
Prefix:MRS
First Name:CARYN
Middle Name:MELANCON
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:MS, LPC, NCC, CSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 LILLIAN MILLER PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-7206
Mailing Address - Country:US
Mailing Address - Phone:214-402-7301
Mailing Address - Fax:
Practice Address - Street 1:2524 LILLIAN MILLER PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-7206
Practice Address - Country:US
Practice Address - Phone:214-402-7301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67152101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool