Provider Demographics
NPI:1578907002
Name:CARR, ELIZABETH E (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:E
Last Name:CARR
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 W MCFARLANE AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4105
Mailing Address - Country:US
Mailing Address - Phone:310-717-2838
Mailing Address - Fax:
Practice Address - Street 1:9454 WILSHIRE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2904
Practice Address - Country:US
Practice Address - Phone:310-717-2838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8146106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist