Provider Demographics
NPI:1730399510
Name:CARR, CANDIS (NCC, LPC, LMFT, CEAP)
Entity type:Individual
Prefix:DR
First Name:CANDIS
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:NCC, LPC, LMFT, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 OAK POINT LN
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4278
Mailing Address - Country:US
Mailing Address - Phone:337-474-5915
Mailing Address - Fax:
Practice Address - Street 1:217 S RYAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5974
Practice Address - Country:US
Practice Address - Phone:337-433-7918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1771101YP2500X
TX13645101YP2500X
LA86106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist