Provider Demographics
NPI:1417052853
Name:CARTER, CAROL J (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:CARTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:CARTER SCHOFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3501 DEL PRADO BLVD S STE 303
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-7222
Mailing Address - Country:US
Mailing Address - Phone:239-317-0265
Mailing Address - Fax:239-673-7681
Practice Address - Street 1:3501 DEL PRADO BLVD S STE 303
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7222
Practice Address - Country:US
Practice Address - Phone:239-317-0265
Practice Address - Fax:239-673-7681
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW68721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106116800Medicaid