MEDICARE: KARINA LEON-CARRILLO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1083430250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARINA LEON-CARRILLO LPC

Provider Business Mailing Address
First Line	:	9041 GARLAND RD UNIT 2062
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3919
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9041 GARLAND RD UNIT 2062
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3919
Country	:	US
Telephone Number	:	903-402-5170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2024
Last Update Date	:	05/06/2026

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