Provider Demographics
NPI:1417341264
Name:CARTER, SHENITRA LASHARI (BS)
Entity Type:Individual
Prefix:
First Name:SHENITRA
Middle Name:LASHARI
Last Name:CARTER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 BUNKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-6712
Mailing Address - Country:US
Mailing Address - Phone:706-325-0022
Mailing Address - Fax:
Practice Address - Street 1:945 BUNKER HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-6712
Practice Address - Country:US
Practice Address - Phone:706-325-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker