Provider Demographics
NPI:1063893998
Name:CHRISTOPHE, EBONY CARRIERE (LPC)
Entity type:Individual
Prefix:MRS
First Name:EBONY
Middle Name:CARRIERE
Last Name:CHRISTOPHE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:EBONY
Other - Middle Name:CHANTRELL
Other - Last Name:CARRIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2929 MILLERVILLE RD STE 4A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2965
Mailing Address - Country:US
Mailing Address - Phone:225-366-9605
Mailing Address - Fax:225-349-8453
Practice Address - Street 1:2929 MILLERVILLE RD STE 4A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2965
Practice Address - Country:US
Practice Address - Phone:225-366-9605
Practice Address - Fax:225-349-8453
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4247101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional