Provider Demographics
NPI:1679802771
Name:PELC, CARRIE JOY (MA, CSAYC)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:JOY
Last Name:PELC
Suffix:
Gender:F
Credentials:MA, CSAYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 APPLEGATE LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-9608
Mailing Address - Country:US
Mailing Address - Phone:812-283-8383
Mailing Address - Fax:812-283-8429
Practice Address - Street 1:1205 APPLEGATE LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-9608
Practice Address - Country:US
Practice Address - Phone:812-283-8383
Practice Address - Fax:812-283-8429
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral