Provider Demographics
NPI:1265081046
Name:SCHROEDER, CARRIE ANN (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20319 SOUTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6021
Mailing Address - Country:US
Mailing Address - Phone:850-232-6297
Mailing Address - Fax:
Practice Address - Street 1:17105 KENTON DR STE 201C
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5654
Practice Address - Country:US
Practice Address - Phone:850-232-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional