Provider Demographics
NPI:1043368632
Name:SPRINGER, CARRIE ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ANN
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5630
Mailing Address - Country:US
Mailing Address - Phone:941-704-6668
Mailing Address - Fax:813-425-5739
Practice Address - Street 1:3005 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5630
Practice Address - Country:US
Practice Address - Phone:941-704-6668
Practice Address - Fax:813-425-5739
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 6536103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7643471 00Medicaid