Provider Demographics
NPI:1841546116
Name:FREY-DAVIS, CARRIE LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LYNN
Last Name:FREY-DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 N LEMANS BLVD
Mailing Address - Street 2:#5301
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1122
Mailing Address - Country:US
Mailing Address - Phone:813-785-9259
Mailing Address - Fax:
Practice Address - Street 1:2021 N LEMANS BLVD
Practice Address - Street 2:#5301
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1122
Practice Address - Country:US
Practice Address - Phone:813-785-9259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW95851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical