Provider Demographics
NPI:1558098749
Name:CARNEGIE, EUGENIE
Entity Type:Individual
Prefix:
First Name:EUGENIE
Middle Name:
Last Name:CARNEGIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8242 SPENCERS TRACE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5944
Mailing Address - Country:US
Mailing Address - Phone:850-405-3430
Mailing Address - Fax:
Practice Address - Street 1:8242 SPENCERS TRACE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-5944
Practice Address - Country:US
Practice Address - Phone:850-405-3430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst