Provider Demographics
NPI:1669197554
Name:CARSON, CHRISTINE (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CARSON
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6177 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76247-6023
Mailing Address - Country:US
Mailing Address - Phone:925-324-3185
Mailing Address - Fax:
Practice Address - Street 1:4925 GREENVILLE AVE STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-0500
Practice Address - Country:US
Practice Address - Phone:214-433-6433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional