Provider Demographics
NPI:1619286234
Name:CARVER, CHRISTOPHER LOYD (MS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LOYD
Last Name:CARVER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5713 S KINGS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2944
Mailing Address - Country:US
Mailing Address - Phone:417-872-8403
Mailing Address - Fax:417-872-8403
Practice Address - Street 1:1531 E SUNSHINE ST
Practice Address - Street 2:SUITE W-29
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1240
Practice Address - Country:US
Practice Address - Phone:417-872-8403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010033344101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health