Provider Demographics
NPI:1043640766
Name:CARTER, ROBERT JR (LMFT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CARTER
Suffix:JR
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 POINSETT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-4932
Mailing Address - Country:US
Mailing Address - Phone:843-281-0061
Mailing Address - Fax:843-492-0255
Practice Address - Street 1:3609 POINSETT ST
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-4932
Practice Address - Country:US
Practice Address - Phone:843-281-0061
Practice Address - Fax:843-492-0255
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4560106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist