Provider Demographics
NPI:1407516198
Name:LUND, CARRIE ELIZABETH (MS, P-CMHT)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:LUND
Suffix:
Gender:F
Credentials:MS, P-CMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 COBBLESTONE BLVD S
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-7075
Mailing Address - Country:US
Mailing Address - Phone:662-892-2885
Mailing Address - Fax:
Practice Address - Street 1:7160 TCHULAHOMA RD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9266
Practice Address - Country:US
Practice Address - Phone:662-536-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health