Provider Demographics
NPI:1730502352
Name:CARR, AMY (MS, LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 GUINEVERE DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5909
Mailing Address - Country:US
Mailing Address - Phone:817-613-7034
Mailing Address - Fax:
Practice Address - Street 1:804 SANTA FE DR BLDG 1
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6525
Practice Address - Country:US
Practice Address - Phone:817-613-7034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional