Provider Demographics
NPI:1750618773
Name:WINTERS, CAROL LYNN (LCPC LPC CRC)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LYNN
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LCPC LPC CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 S MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SNOWFLAKE
Mailing Address - State:AZ
Mailing Address - Zip Code:85937-5269
Mailing Address - Country:US
Mailing Address - Phone:928-532-0222
Mailing Address - Fax:
Practice Address - Street 1:184 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:SNOWFLAKE
Practice Address - State:AZ
Practice Address - Zip Code:85937-5269
Practice Address - Country:US
Practice Address - Phone:928-532-0222
Practice Address - Fax:406-755-5525
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT151101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional