Provider Demographics
NPI:1801520382
Name:WATERS, CARA LEIGH (LPC-A)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:LEIGH
Last Name:WATERS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17210 CAMPBELL RD STE 175
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-4201
Mailing Address - Country:US
Mailing Address - Phone:972-975-9100
Mailing Address - Fax:
Practice Address - Street 1:17210 CAMPBELL RD STE 175
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-4201
Practice Address - Country:US
Practice Address - Phone:972-975-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89104101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional