Provider Demographics
NPI:1720009087
Name:CARRIER-REID, CHRISANN MULLER (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISANN
Middle Name:MULLER
Last Name:CARRIER-REID
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 PARK DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6738
Mailing Address - Country:US
Mailing Address - Phone:352-365-6506
Mailing Address - Fax:352-787-9071
Practice Address - Street 1:1514 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-4857
Practice Address - Country:US
Practice Address - Phone:352-365-6506
Practice Address - Fax:352-365-6596
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW81451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
U9016ZOtherMEDICARE PROVIDER NO.