Healthcare Provider Details

I. General information

NPI: 1982415865
Provider Name (Legal Business Name): KAREN CARPENTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2025
Last Update Date: 01/18/2025
Certification Date: 01/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N STATE LINE AVE
TEXARKANA AR
71854-5926
US

IV. Provider business mailing address

13 RIVER PLANTATION
TEXARKANA TX
75503-9777
US

V. Phone/Fax

Practice location:
  • Phone: 903-336-3484
  • Fax:
Mailing address:
  • Phone: 903-280-4132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP2501002
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: