Provider Demographics
NPI:1386065233
Name:CAGE, CARLA
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:CAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 KITTY HAWK RD STE 211
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3829
Mailing Address - Country:US
Mailing Address - Phone:210-255-7586
Mailing Address - Fax:210-598-1910
Practice Address - Street 1:3934 CYPRESS CREEK PKWY STE 152
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3546
Practice Address - Country:US
Practice Address - Phone:210-255-7586
Practice Address - Fax:210-598-1910
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-19
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional