Provider Demographics
NPI:1508048166
Name:CARTER, GARREN JEROME (LPC-MHSP, NCC)
Entity Type:Individual
Prefix:MR
First Name:GARREN
Middle Name:JEROME
Last Name:CARTER
Suffix:
Gender:M
Credentials:LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 ADDINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1728
Mailing Address - Country:US
Mailing Address - Phone:615-330-7059
Mailing Address - Fax:
Practice Address - Street 1:450 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2180
Practice Address - Country:US
Practice Address - Phone:615-330-7059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002875101YM0800X
NC3549101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health