Provider Demographics
NPI:1073593414
Name:CARPER, NANCY A (LCPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:CARPER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52733-0361
Mailing Address - Country:US
Mailing Address - Phone:563-242-5316
Mailing Address - Fax:563-242-3128
Practice Address - Street 1:1405 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IL
Practice Address - Zip Code:61356-9771
Practice Address - Country:US
Practice Address - Phone:815-872-2100
Practice Address - Fax:363-242-3128
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL623783OtherBCBS
IL078357OtherHEALTH ALLIANCE
20206303401OtherJOHN DEERE