Provider Demographics
NPI:1407516198
Name:LUND, CARRIE ELIZABETH (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:LUND
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7185 SWINNEA RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-6003
Mailing Address - Country:US
Mailing Address - Phone:901-501-5645
Mailing Address - Fax:
Practice Address - Street 1:7185 SWINNEA RD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-6003
Practice Address - Country:US
Practice Address - Phone:901-501-5645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MS3108101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health