Provider Demographics
NPI:1255737128
Name:EUGENE, CARLA (LPCC-S)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:
Last Name:EUGENE
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:MS
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:LEMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2661 LILYPARK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-5544
Mailing Address - Country:US
Mailing Address - Phone:330-705-6865
Mailing Address - Fax:
Practice Address - Street 1:1255 N HAMILTON RD # 139
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6785
Practice Address - Country:US
Practice Address - Phone:614-723-9193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1000239101YM0800X
OHE.1700236-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health