Provider Demographics
NPI:1821227455
Name:CARTER, DEBRA ANN (LPCC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 MADEIRA DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-3613
Mailing Address - Country:US
Mailing Address - Phone:505-205-0763
Mailing Address - Fax:505-554-3435
Practice Address - Street 1:3321B CANDELARIA RD NE
Practice Address - Street 2:STE 402
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1966
Practice Address - Country:US
Practice Address - Phone:505-205-0763
Practice Address - Fax:505-554-3435
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH146601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM11578777Medicaid