Provider Demographics
NPI:1477364487
Name:CARRIER, CODY C
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:C
Last Name:CARRIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30125 AGOURA RD STE F
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4337
Mailing Address - Country:US
Mailing Address - Phone:586-904-0239
Mailing Address - Fax:
Practice Address - Street 1:30125 AGOURA RD STE F
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4337
Practice Address - Country:US
Practice Address - Phone:586-904-0239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health