Provider Demographics
NPI:1811154644
Name:HALLADAY, CARRIE A (LPC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:HALLADAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 PEEKS HILL RD
Mailing Address - Street 2:
Mailing Address - City:OHATCHEE
Mailing Address - State:AL
Mailing Address - Zip Code:36271-7799
Mailing Address - Country:US
Mailing Address - Phone:256-282-3885
Mailing Address - Fax:
Practice Address - Street 1:124 N 5TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-3708
Practice Address - Country:US
Practice Address - Phone:256-282-3885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2392101YP2500X
101Y00000X, 101YM0800X, 101YA0400X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist