Provider Demographics
NPI:1245994201
Name:WILTSHIRE, CARLA L (MS, LPC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:L
Last Name:WILTSHIRE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 YESTEREVE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6959
Mailing Address - Country:US
Mailing Address - Phone:832-462-4439
Mailing Address - Fax:713-485-0675
Practice Address - Street 1:7457 HARWIN DR STE 338
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2053
Practice Address - Country:US
Practice Address - Phone:713-393-7804
Practice Address - Fax:713-485-0657
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82437101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16785694OtherID