Provider Demographics
NPI:1790267771
Name:GALLOWAY, CARISA (LPC)
Entity Type:Individual
Prefix:
First Name:CARISA
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CARISA
Other - Middle Name:
Other - Last Name:SILVESAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC INTERN
Mailing Address - Street 1:5313 HONEYSUCKLE BR
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-2277
Mailing Address - Country:US
Mailing Address - Phone:425-408-2517
Mailing Address - Fax:
Practice Address - Street 1:5313 HONEYSUCKLE BR
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-2277
Practice Address - Country:US
Practice Address - Phone:108-162-4552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78627101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional