Provider Demographics
NPI:1720127350
Name:JAMES, CAROL ANN (LPC/MHSP-S)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPC/MHSP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4542
Mailing Address - Country:US
Mailing Address - Phone:931-220-0522
Mailing Address - Fax:
Practice Address - Street 1:1716 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4542
Practice Address - Country:US
Practice Address - Phone:931-220-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN2900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2900OtherLPC/MHSP-S