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General NPI Number Information
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NPI Number | 1699326546
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Entity Type | Individual
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Provider Name | TERRENCE LENORRIS CARN SR. LCSW, MCAP
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Gender | Male
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 1375 GATEWAY BLVD STE 29
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8304
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Country | US
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Telephone | 561-379-1440
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Fax | 561-471-3288
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Provider Business Mailing Address
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Address Line | 6586 HYPOLUXO RD # 230
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City | LAKE WORTH
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State | FL
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Zip | 33467-7678
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Country | US
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Telephone | 561-248-8900
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Fax | 561-471-3288
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MCAP100694
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW15330
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License Number State | FL
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