Individual
CARRIE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
807 8TH ST STE 1212, WICHITA FALLS, TX 76301
(940) 264-1212
(940) 264-1213
Mailing address
807 8TH ST STE 1212, WICHITA FALLS, TX 76301-3341
(940) 264-1212
(940) 264-1213
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC14599
TX
101YP2500X
Professional Counselor
Primary
14599
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027684202
—
TX
05
—
276842-01
—
TX
01
—
3623LC
BCBS PROVIDER ID
TX
01
—
60971
HORIZON BEHAVIORAL ID
TX
01
—
LPC14599
TEXAS STATE LICENSE
TX
Enumeration date
09/14/2005
Last updated
03/04/2026
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