Provider Demographics
NPI:1295807758
Name:GREENLEAF, CAROLYN H (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:H
Last Name:GREENLEAF
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3740 NORTH JOSEY LANE
Mailing Address - Street 2:#246
Mailing Address - City:CAROOLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007
Mailing Address - Country:US
Mailing Address - Phone:972-492-0755
Mailing Address - Fax:972-492-1398
Practice Address - Street 1:3740 N JOSEY LN
Practice Address - Street 2:#246
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2474
Practice Address - Country:US
Practice Address - Phone:972-492-0755
Practice Address - Fax:972-492-1398
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX11120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S86VOtherBLUE CROSS BLUE SHIELD