Provider Demographics
NPI:1811488877
Name:BABE, CARRIE MILLIS (MS, LMFT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:MILLIS
Last Name:BABE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23095 KIRKLAND CT
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-8519
Mailing Address - Country:US
Mailing Address - Phone:773-531-4360
Mailing Address - Fax:
Practice Address - Street 1:23095 KIRKLAND CT
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167
Practice Address - Country:US
Practice Address - Phone:773-531-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001258-1106H00000X
MI4101006796106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist