Provider Demographics
NPI:1558042549
Name:CARR, TAMARA ROSE (LGPC)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:ROSE
Last Name:CARR
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WYEGATE CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3358
Mailing Address - Country:US
Mailing Address - Phone:443-415-8728
Mailing Address - Fax:
Practice Address - Street 1:10450 SHAKER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1143
Practice Address - Country:US
Practice Address - Phone:240-756-6516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14145101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health