Provider Demographics
NPI:1295563898
Name:CARRIAGE LANE THERAPY LLC
Entity type:Organization
Organization Name:CARRIAGE LANE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LMHC, LPC
Authorized Official - Phone:267-477-3761
Mailing Address - Street 1:706 WAGENER LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8253
Mailing Address - Country:US
Mailing Address - Phone:267-477-3761
Mailing Address - Fax:
Practice Address - Street 1:706 WAGENER LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8253
Practice Address - Country:US
Practice Address - Phone:267-477-3761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty