Provider Demographics
NPI:1932828142
Name:ACKROYD, CARRIE ANNE (MSED)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:ACKROYD
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANNE
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:31 AUTUMN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2320
Mailing Address - Country:US
Mailing Address - Phone:731-924-8868
Mailing Address - Fax:
Practice Address - Street 1:31 AUTUMN VALLEY DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2320
Practice Address - Country:US
Practice Address - Phone:731-924-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health