Provider Demographics
NPI:1871162354
Name:BEAIRD, CARRIE (LPC-S, LCDC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:BEAIRD
Suffix:
Gender:F
Credentials:LPC-S, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17304 PRESTON RD STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5645
Mailing Address - Country:US
Mailing Address - Phone:972-448-8797
Mailing Address - Fax:
Practice Address - Street 1:17304 PRESTON RD STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5645
Practice Address - Country:US
Practice Address - Phone:972-448-8797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16711101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor