Provider Demographics
NPI:1659882009
Name:PEED, CARRIE (LPCA)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:PEED
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5803 PERENNIAL LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3586
Mailing Address - Country:US
Mailing Address - Phone:310-210-7333
Mailing Address - Fax:
Practice Address - Street 1:6209 OLEANDER DR STE 218
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3583
Practice Address - Country:US
Practice Address - Phone:310-210-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional