Provider Demographics
NPI:1932982642
Name:CARSON, STEPHEN (MS, LPC-A, NCC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:CARSON
Suffix:
Gender:M
Credentials:MS, LPC-A, NCC
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 862006
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-2006
Mailing Address - Country:US
Mailing Address - Phone:214-216-1024
Mailing Address - Fax:
Practice Address - Street 1:1705 GENEVA LANE.
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075
Practice Address - Country:US
Practice Address - Phone:214-216-1024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89233101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health