Provider Demographics
NPI:1114080256
Name:MUIR, CAROLYN STEWART (LPC, PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:STEWART
Last Name:MUIR
Suffix:
Gender:F
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E3092 THORNAPPLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ANIWA
Mailing Address - State:WI
Mailing Address - Zip Code:54408-9642
Mailing Address - Country:US
Mailing Address - Phone:715-446-2990
Mailing Address - Fax:715-848-2030
Practice Address - Street 1:300 3RD ST
Practice Address - Street 2:SUITE 207
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-5458
Practice Address - Country:US
Practice Address - Phone:715-848-5022
Practice Address - Fax:715-848-2030
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI993-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health