Provider Demographics
NPI:1396885950
Name:CARSWELL, CINDY ELAINE (LPC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:ELAINE
Last Name:CARSWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 FM 3174
Mailing Address - Street 2:
Mailing Address - City:JOAQUIN
Mailing Address - State:TX
Mailing Address - Zip Code:75954-2436
Mailing Address - Country:US
Mailing Address - Phone:936-707-2803
Mailing Address - Fax:
Practice Address - Street 1:220 FIELD ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3934
Practice Address - Country:US
Practice Address - Phone:936-590-9864
Practice Address - Fax:936-590-9619
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1484289-01Medicaid