Provider Demographics
NPI:1619288024
Name:CARTER, JENNIFER KAYE (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAYE
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 1:17306 W COPPER LAKES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4284
Mailing Address - Country:US
Mailing Address - Phone:713-449-0138
Mailing Address - Fax:
Practice Address - Street 1:17306 W COPPER LAKES DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-4284
Practice Address - Country:US
Practice Address - Phone:713-449-0138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI417101YM0800X
TX63664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health