Provider Demographics
NPI:1548427396
Name:PEASE-CARTER, CHEYENNE (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:CHEYENNE
Middle Name:
Last Name:PEASE-CARTER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 THOMPSON TER
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5850
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5009 THOMPSON TER
Practice Address - Street 2:SUITE 103
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5850
Practice Address - Country:US
Practice Address - Phone:817-205-1285
Practice Address - Fax:817-503-2108
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60431101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional