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General NPI Number Information
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NPI Number | 1053474270
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Entity Type | Individual
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Provider Name | HOLLY EDEN CARSON MA, LPC, LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 316 S 2ND ST SUITE A
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City | SAINT CHARLES
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State | MO
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Zip | 63301-3402
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Country | US
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Telephone | 314-995-1970
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Fax | 636-561-4796
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Provider Business Mailing Address
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Address Line | PO BOX 27897
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City | SAINT LOUIS
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State | MO
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Zip | 63146-1397
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Country | US
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Telephone | 314-995-1970
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Fax | 636-561-4796
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 000447
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 002823
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License Number State | MO
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