Provider Demographics
NPI:1649586165
Name:MERRILL, KARA RENAE (LPC)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:RENAE
Last Name:MERRILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:KARA
Other - Middle Name:RENAE
Other - Last Name:MARCUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4840 W PANTHER CREEK DR
Mailing Address - Street 2:STE. 212
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3527
Mailing Address - Country:US
Mailing Address - Phone:281-465-9229
Mailing Address - Fax:281-465-9235
Practice Address - Street 1:4840 W PANTHER CREEK DR
Practice Address - Street 2:STE. 212
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3527
Practice Address - Country:US
Practice Address - Phone:281-465-9229
Practice Address - Fax:281-465-9235
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional