Provider Demographics
NPI:1649015116
Name:CARR, STEPHEN P (LCMHC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:P
Last Name:CARR
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 KERY DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2817
Mailing Address - Country:US
Mailing Address - Phone:336-402-5796
Mailing Address - Fax:
Practice Address - Street 1:2409 KERY DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2817
Practice Address - Country:US
Practice Address - Phone:336-402-5796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4170101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health