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General NPI Number Information
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NPI Number | 1356898431
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Entity Type | Individual
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Provider Name | CAROLYN KINGSLEY
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Gender | Female
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1501 CEMETERY HILL RD
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City | CARROLLTON
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State | TX
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Zip | 75007-5096
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Country | US
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Telephone | 778-392-7795
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Fax |
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Provider Business Mailing Address
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Address Line | 1405-1471 ST PAUL STREET
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City | KELOWNA
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State | BRITISH COLUMBIA
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Zip | V1Y 0K7
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Country | CA
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Telephone |
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 73392
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 73392
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 73392
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 73392
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0017660
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License Number State | CO
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