Provider Demographics
NPI:1275267684
Name:CARTER, GEORGE-ANN MARIE (PRS)
Entity Type:Individual
Prefix:MISS
First Name:GEORGE-ANN
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 S CHAMPION AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-3028
Mailing Address - Country:US
Mailing Address - Phone:614-622-5155
Mailing Address - Fax:
Practice Address - Street 1:1234 S CHAMPION AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-3028
Practice Address - Country:US
Practice Address - Phone:614-622-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCHW.001514172V00000X
OHAPS.003389175T00000X
CHW.001514171M00000X
OHCDCA.184702101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator