Provider Demographics
NPI:1134463821
Name:CARR, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:CARR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:BEATTY
Mailing Address - State:NV
Mailing Address - Zip Code:89003-1010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MCDONALD ST
Practice Address - Street 2:
Practice Address - City:BEATTY
Practice Address - State:NV
Practice Address - Zip Code:89003-8900
Practice Address - Country:US
Practice Address - Phone:586-883-5557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NVC15184101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst