Provider Demographics
NPI:1811255748
Name:MULCAHY EARNHARDT, CHRISTINE ANNE (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE
Last Name:MULCAHY EARNHARDT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1632 BLACKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5121
Mailing Address - Country:US
Mailing Address - Phone:919-327-0512
Mailing Address - Fax:
Practice Address - Street 1:1632 BLACKSTONE DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5121
Practice Address - Country:US
Practice Address - Phone:919-327-0512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-28
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7661101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75914OtherTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL