Provider Demographics
NPI:1295383081
Name:BROWN, CARISSA (MA, LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 MARSH LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4851
Mailing Address - Country:US
Mailing Address - Phone:469-702-1387
Mailing Address - Fax:
Practice Address - Street 1:13355 NOEL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6602
Practice Address - Country:US
Practice Address - Phone:469-702-1387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health