Provider Demographics
NPI:1982037479
Name:KEMP, CARISSA (LPC)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:KEMP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CARISSA
Other - Middle Name:
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2502 FALCON LN
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-7324
Mailing Address - Country:US
Mailing Address - Phone:918-424-6765
Mailing Address - Fax:
Practice Address - Street 1:604 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5814
Practice Address - Country:US
Practice Address - Phone:918-302-0052
Practice Address - Fax:918-302-0082
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional