Provider Demographics
NPI:1679381198
Name:MCCAIN, CARSON (MA, LPC)
Entity type:Individual
Prefix:
First Name:CARSON
Middle Name:
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7844
Mailing Address - Country:US
Mailing Address - Phone:940-389-6908
Mailing Address - Fax:
Practice Address - Street 1:8140 WALNUT HILL LN STE 440
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4396
Practice Address - Country:US
Practice Address - Phone:469-709-9250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85406101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional