Provider Demographics
NPI:1083228050
Name:CARTER, LASONJA D (LPC)
Entity Type:Individual
Prefix:
First Name:LASONJA
Middle Name:D
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 FROST DR SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-4531
Mailing Address - Country:US
Mailing Address - Phone:256-616-7756
Mailing Address - Fax:
Practice Address - Street 1:2920 FROST DR SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-4531
Practice Address - Country:US
Practice Address - Phone:256-616-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3698101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional