Healthcare Provider Details

I. General information

NPI: 1407771504
Provider Name (Legal Business Name): JOSHUA CHARLES CARR LGPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 E CHURCHVILLE RD STE 300
BEL AIR MD
21014-3485
US

IV. Provider business mailing address

616 E 37TH ST
BALTIMORE MD
21218-2531
US

V. Phone/Fax

Practice location:
  • Phone: 800-305-2089
  • Fax:
Mailing address:
  • Phone: 859-408-5784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: