Provider Demographics
NPI:1720339112
Name:MANY, CARRIE L (LPC, CAADC, NCC, CTP)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:L
Last Name:MANY
Suffix:
Gender:F
Credentials:LPC, CAADC, NCC, CTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14820 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:MI
Mailing Address - Zip Code:48808-9708
Mailing Address - Country:US
Mailing Address - Phone:517-410-9494
Mailing Address - Fax:
Practice Address - Street 1:1712 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-2825
Practice Address - Country:US
Practice Address - Phone:517-410-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1720339112OtherMC LAREN HEALTH PLAN
MI1720339112OtherBLUE CROSS BLUE SHIELD MICHIGAN
MI1720339112Medicaid