Provider Demographics
NPI:1295989085
Name:HORTON, CAROL (LPC-S)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1305
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78667-1305
Mailing Address - Country:US
Mailing Address - Phone:512-757-1840
Mailing Address - Fax:512-292-1144
Practice Address - Street 1:302 W. HOPKINS
Practice Address - Street 2:STE. 4
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-4465
Practice Address - Country:US
Practice Address - Phone:512-757-1840
Practice Address - Fax:512-292-1144
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14064101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196590702Medicaid