Provider Demographics
NPI:1548475973
Name:GLEBE, CARRIE CORINE (LMHC, LPC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:CORINE
Last Name:GLEBE
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15191 NE 51ST PL
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-6433
Mailing Address - Country:US
Mailing Address - Phone:352-374-5600
Mailing Address - Fax:352-375-0298
Practice Address - Street 1:15191 NE 51ST PL
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-6433
Practice Address - Country:US
Practice Address - Phone:352-374-5600
Practice Address - Fax:352-375-0298
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017626101YM0800X
FLMH 7694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL765909100Medicaid