Provider Demographics
NPI:1649874322
Name:CARR, ERIC MICHAEL (MAP, LPC, EDD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MICHAEL
Last Name:CARR
Suffix:
Gender:M
Credentials:MAP, LPC, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20351 HIGHWAY 6 STE B
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3882
Mailing Address - Country:US
Mailing Address - Phone:979-233-1584
Mailing Address - Fax:832-753-7479
Practice Address - Street 1:21902 CHENANGO LAKE DR
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-6663
Practice Address - Country:US
Practice Address - Phone:281-543-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77666101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX77666OtherLPC LICENSE