Provider Demographics
NPI:1932898590
Name:HIRST, CARRIE LEE (LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LEE
Last Name:HIRST
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 CORABELLS XING
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3221
Mailing Address - Country:US
Mailing Address - Phone:404-971-8236
Mailing Address - Fax:
Practice Address - Street 1:2450 ATLANTA HWY STE 1403
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1277
Practice Address - Country:US
Practice Address - Phone:404-971-8236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011568101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional