Provider Demographics
NPI:1689934838
Name:CARTER, CASSIE JO (LPCC)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:JO
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:JO
Other - Last Name:MC DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:204 COOK RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9600
Mailing Address - Country:US
Mailing Address - Phone:513-228-7800
Mailing Address - Fax:513-695-2952
Practice Address - Street 1:953 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2921
Practice Address - Country:US
Practice Address - Phone:937-383-4441
Practice Address - Fax:937-383-2916
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-1100234101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional