Provider Demographics
NPI:1568036150
Name:RAWLS, CARLA LEE (LPC, NCC, NCSC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:LEE
Last Name:RAWLS
Suffix:
Gender:F
Credentials:LPC, NCC, NCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5891 U S HIGHWAY 49 STE 60-119
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-2810
Mailing Address - Country:US
Mailing Address - Phone:601-336-0805
Mailing Address - Fax:
Practice Address - Street 1:607 CORINNE ST STE C3
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-3852
Practice Address - Country:US
Practice Address - Phone:601-336-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-0606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional