Provider Demographics
NPI:1386359271
Name:PINTO, CARLA DENISE (LPC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:DENISE
Last Name:PINTO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:DENISSE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2615 FOREST PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-2224
Mailing Address - Country:US
Mailing Address - Phone:682-319-9609
Mailing Address - Fax:
Practice Address - Street 1:2615 FOREST PARK BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-2224
Practice Address - Country:US
Practice Address - Phone:682-319-9609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74144101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional