Provider Demographics
NPI:1275221590
Name:HORTON, CARRIE RAE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:RAE
Last Name:HORTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:RAE
Other - Last Name:KIRBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4300 FORDHAM CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1142
Mailing Address - Country:US
Mailing Address - Phone:804-310-1952
Mailing Address - Fax:
Practice Address - Street 1:350 POPLAR DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9367
Practice Address - Country:US
Practice Address - Phone:866-546-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional