| Organization Name: | CARRIE VIRGINIA PATE THERAPY CENTER, LLC |
| NPI Number: | 1013374347 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARRIE V PATE (OWNER AND PRACTITIONER) |
| Mailing Address: | 2112 Bienville Blvd Suite L-1 Ocean Springs |
| State: | MS US |
| Postal Code: | 395643052 |
| Phone Number: | 2282151744 |
| Fax Number: | 2282151721 |
| NPI Enumeration Date: | 01/17/2016 |
| NPI Last Update Date: | 01/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C6890 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |