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General NPI Number Information
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NPI Number | 1356850333
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Entity Type | Organization
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Legal Business Name | KIM C CARSON
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 201 W VIRGINIA ST
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City | MCKINNEY
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State | TX
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Zip | 75069-4418
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Country | US
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Telephone | 972-754-3980
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W VIRGINIA ST
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City | MCKINNEY
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State | TX
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Zip | 75069-4418
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Country | US
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Telephone | 972-754-3980
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | JOSE LOPEZ
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Credential | LPC
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Telephone | 972-754-3980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 68396
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License Number State | TX
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