Provider Demographics
NPI:1578289294
Name:MESSICK, CARRIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MESSICK
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 IRONSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-1372
Mailing Address - Country:US
Mailing Address - Phone:717-926-9411
Mailing Address - Fax:
Practice Address - Street 1:75 IRONSTONE DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-1372
Practice Address - Country:US
Practice Address - Phone:717-926-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC009352OtherSTATE LICENSE