Provider Demographics
NPI:1396847885
Name:CARR, DEBRA LEE (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:LEE
Last Name:CARR
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5192 OLD HIGHWAY 11
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-6222
Mailing Address - Country:US
Mailing Address - Phone:601-450-0982
Mailing Address - Fax:601-261-0508
Practice Address - Street 1:5192 OLD HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-6222
Practice Address - Country:US
Practice Address - Phone:601-450-0982
Practice Address - Fax:601-261-0508
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0914101YP2500X
MS348106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist