Provider Demographics
NPI:1972268050
Name:CARBREY, AGNES LUCILLE (LPC)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:LUCILLE
Last Name:CARBREY
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 1:360 SADDLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-6234
Mailing Address - Country:US
Mailing Address - Phone:540-570-9831
Mailing Address - Fax:
Practice Address - Street 1:241 GREENHOUSE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3717
Practice Address - Country:US
Practice Address - Phone:540-570-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health