Provider Demographics
NPI:1376952465
Name:CARTER, AMANDA (BA, CMHP)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:BA, CMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8623 N WAYNE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-1137
Mailing Address - Country:US
Mailing Address - Phone:734-513-7598
Mailing Address - Fax:734-513-8698
Practice Address - Street 1:8623 N WAYNE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1137
Practice Address - Country:US
Practice Address - Phone:734-513-7598
Practice Address - Fax:734-513-8698
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator