Provider Demographics
NPI:1912683749
Name:KIRKHAM, CARRIE (LPC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:KIRKHAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-0014
Mailing Address - Country:US
Mailing Address - Phone:972-388-2000
Mailing Address - Fax:972-524-1002
Practice Address - Street 1:2435 RIDGE RD STE 107
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5533
Practice Address - Country:US
Practice Address - Phone:972-722-2685
Practice Address - Fax:972-692-0604
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional