Provider Demographics
NPI:1447038807
Name:MARCHANT, CARRIE DAVIS (PMFT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:DAVIS
Last Name:MARCHANT
Suffix:
Gender:F
Credentials:PMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-0424
Mailing Address - Country:US
Mailing Address - Phone:423-262-0180
Mailing Address - Fax:423-262-0181
Practice Address - Street 1:501 N CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-5598
Practice Address - Country:US
Practice Address - Phone:423-262-0180
Practice Address - Fax:423-262-0181
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2042106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist