Provider Demographics
NPI:1457730285
Name:CARPENTER, MARY ALICE MARTIN (LMFT-A)
Entity Type:Individual
Prefix:
First Name:MARY ALICE
Middle Name:MARTIN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:MARY ALICE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1318 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-4214
Mailing Address - Country:US
Mailing Address - Phone:832-433-5241
Mailing Address - Fax:
Practice Address - Street 1:3418 MERCER ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6525
Practice Address - Country:US
Practice Address - Phone:713-561-3884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99370176B00000X
374J00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula