Provider Demographics
NPI:1073851010
Name:CARR, AMMIE LYNN (LPC, NCC, LCDC)
Entity Type:Individual
Prefix:
First Name:AMMIE
Middle Name:LYNN
Last Name:CARR
Suffix:
Gender:F
Credentials:LPC, NCC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11325 IH 37 APT 3103
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-3351
Mailing Address - Country:US
Mailing Address - Phone:361-816-0111
Mailing Address - Fax:
Practice Address - Street 1:11325 IH 37 APT 3103
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-3351
Practice Address - Country:US
Practice Address - Phone:361-816-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12182101YA0400X
TX71080101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health