Provider Demographics
NPI:1407007479
Name:CARR, NASHUNDA (LPC)
Entity Type:Individual
Prefix:MS
First Name:NASHUNDA
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:LPC
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 382
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31202-0382
Mailing Address - Country:US
Mailing Address - Phone:478-787-3447
Mailing Address - Fax:
Practice Address - Street 1:630 W CHARLTON ST
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2303
Practice Address - Country:US
Practice Address - Phone:478-445-3201
Practice Address - Fax:445-478-4963
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004981101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX77671OtherLPC
GALPC004981OtherLPC