Mary L Carlson, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

79257 Issued in TX

Practice address

1300 S University Dr Ste 306
Fort Worth, TX 76107-5746

Phone

(844) 824-8775

NPI assigned

Sep 14, 2016

Last updated

Jul 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progressive Behavioral Health, PLLC

  dba LifeStance Health

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238
  Medicare reassignment NPD
• PHC of Buffalo Grove Clinical Psychology

  dba Portrait Health Centers

  • Psychologist
  • Vernon Hills, IL
  • NPI 1235430612
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1679021166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S FRIENDSWOOD DR STE 200",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463989",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S UNIVERSITY DR STE 306",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075746",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "79257",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79257",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014030086",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Louise Carlson
• Carla Michelle Carlson, LVN
• Christy Y Carlson
• David K. Carlson, PSY.D.
• Jade Catherine Carlson, DDS
• Nancy Valerie Carlson
• Charles A Carlton, MD
• Joshua Carlton, DO
• Michael S. Carlton, FNP
• Ariel Amber-Lynn Carmack

• Professional Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.