Provider Demographics
NPI:1083785554
Name:CARR, CARRIE ANN (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:CARR
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:CHEREP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LCPC
Mailing Address - Street 1:7300 W COLLEGE DR STE 203
Mailing Address - Street 2:PALOS HEIGHTS
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1183
Mailing Address - Country:US
Mailing Address - Phone:708-448-7848
Mailing Address - Fax:708-448-7845
Practice Address - Street 1:7300 W COLLEGE DR STE 203
Practice Address - Street 2:PALOS HEIGHTS
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1183
Practice Address - Country:US
Practice Address - Phone:708-448-7848
Practice Address - Fax:708-448-7845
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2053101YP2500X
IL180-004040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional