Provider Demographics
NPI:1073805750
Name:CARR, AMY DELL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:DELL
Last Name:CARR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79411-1739
Mailing Address - Country:US
Mailing Address - Phone:817-360-4236
Mailing Address - Fax:806-568-2316
Practice Address - Street 1:7905 SAN FELIPE BLVD
Practice Address - Street 2:# 216
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-7987
Practice Address - Country:US
Practice Address - Phone:817-360-4236
Practice Address - Fax:512-597-4629
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53253104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker