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General NPI Number Information
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NPI Number | 1497273759
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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 | 09/06/2017
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 201 W. VIRGINIA SUITE 203
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City | MCKINNEY
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State | TX
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Zip | 75069
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Country | US
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Telephone | 972-743-2324
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W. VIRGINIA SUITE 203
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City | MCKINNEY
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State | TX
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Zip | 75069
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Country | US
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Telephone | 972-743-2324
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | KIM C CARSON
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Credential | LPC
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Telephone | 972-743-2324
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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 | 68346
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 19454
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License Number State | TX
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