Provider Demographics
NPI:1477868727
Name:CARR, HARRIET Z (LCSW)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:Z
Last Name:CARR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 CENTRE LAKE DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907
Mailing Address - Country:US
Mailing Address - Phone:321-768-6420
Mailing Address - Fax:321-768-6324
Practice Address - Street 1:490 CENTRE LAKE DRIVE
Practice Address - Street 2:SUITE 150
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907
Practice Address - Country:US
Practice Address - Phone:321-768-6420
Practice Address - Fax:321-768-6324
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5601106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist