Provider Demographics
NPI:1114126877
Name:CARTER, MICHAEL PRESTON (PHD LPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PRESTON
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4741 CENTRAL ST
Mailing Address - Street 2:SUITE 251
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1533
Mailing Address - Country:US
Mailing Address - Phone:816-277-4290
Mailing Address - Fax:
Practice Address - Street 1:4741 CENTRAL ST
Practice Address - Street 2:SUITE 251
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1533
Practice Address - Country:US
Practice Address - Phone:816-277-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional