Provider Demographics
NPI:1245070697
Name:CARNEY, MARANDA SEA (LPC-MHSP (TEMP))
Entity type:Individual
Prefix:
First Name:MARANDA
Middle Name:SEA
Last Name:CARNEY
Suffix:
Gender:F
Credentials:LPC-MHSP (TEMP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 MILLER ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-4521
Mailing Address - Country:US
Mailing Address - Phone:615-423-6794
Mailing Address - Fax:
Practice Address - Street 1:631 MILLER ESTATES RD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4521
Practice Address - Country:US
Practice Address - Phone:615-423-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health