Individual
CAROLYN K MCCOMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED., LPC
Contact information
Practice address
101 S TRINITY ST, DECATUR, TX 76234-1819
(940) 627-1630
(940) 626-3741
Mailing address
101 S TRINITY ST, DECATUR, TX 76234-1819
(940) 627-1630
(940) 626-3741
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
19764
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10035138
AMERIGROUP PROV. NUMBER
TX
05
—
175788201
—
TX
01
—
84788L
BCBS PROVIDER NUMBER
TX
Enumeration date
10/18/2006
Last updated
03/25/2011
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