Provider Demographics
NPI:1225182397
Name:CARRIGAN-HOUSER, LARUE (MHS,CAC,LPC,CCJP)
Entity Type:Individual
Prefix:MRS
First Name:LARUE
Middle Name:
Last Name:CARRIGAN-HOUSER
Suffix:
Gender:F
Credentials:MHS,CAC,LPC,CCJP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-2738
Mailing Address - Country:US
Mailing Address - Phone:610-434-3202
Mailing Address - Fax:610-434-3202
Practice Address - Street 1:1147 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2738
Practice Address - Country:US
Practice Address - Phone:610-434-3202
Practice Address - Fax:610-434-3202
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4280101YA0400X
PAPC000351101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional