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General NPI Number Information
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NPI Number | 1184057945
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Entity Type | Individual
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Provider Name | TIESHA MIA CARR ED.D, LPC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 1293 N LAKEVIEW DR
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City | PALATINE
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State | IL
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Zip | 60067-2093
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Country | US
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Telephone | 985-326-1882
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Fax |
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Provider Business Mailing Address
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Address Line | 1293 N LAKEVIEW DR
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City | PALATINE
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State | IL
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Zip | 60067-2093
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Country | US
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Telephone | 443-850-1701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701007337
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC6047
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7111
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License Number State | LA
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