Provider Demographics
NPI:1477510253
Name:CARTER, PATRICIA LORRAINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LORRAINE
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SMALL POND DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-3113
Mailing Address - Country:US
Mailing Address - Phone:706-865-2716
Mailing Address - Fax:706-348-1952
Practice Address - Street 1:973 ENOTA AVE NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1700
Practice Address - Country:US
Practice Address - Phone:770-532-9596
Practice Address - Fax:770-205-3218
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional