Provider Demographics
NPI:1073927224
Name:CARTER AND EVANS MFT LLC
Entity Type:Organization
Organization Name:CARTER AND EVANS MFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-258-1272
Mailing Address - Street 1:1509 W SWANN AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2572
Mailing Address - Country:US
Mailing Address - Phone:813-258-1272
Mailing Address - Fax:813-251-3614
Practice Address - Street 1:1509 W SWANN AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2572
Practice Address - Country:US
Practice Address - Phone:813-258-1272
Practice Address - Fax:813-251-3614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty