Provider Demographics
NPI:1538488499
Name:CARTER, KATHY M (MS)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:M
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:M
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:207 1/2 N HARPER ST
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-3943
Mailing Address - Country:US
Mailing Address - Phone:918-506-8505
Mailing Address - Fax:
Practice Address - Street 1:213 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-4203
Practice Address - Country:US
Practice Address - Phone:918-649-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health