Provider Demographics
NPI:1558899500
Name:CARTER, CODIE LYNN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CODIE
Middle Name:LYNN
Last Name:CARTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:CODIE
Other - Middle Name:LYNN
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1465 N UNION BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2885
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1465 N UNION BLVD STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2885
Practice Address - Country:US
Practice Address - Phone:719-492-3699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker