Provider Demographics
NPI:1851763296
Name:CARTER, SHELA MARIE (LPC,LCDC, CART)
Entity Type:Individual
Prefix:
First Name:SHELA
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPC,LCDC, CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7833 COROZAL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-2125
Mailing Address - Country:US
Mailing Address - Phone:915-487-2594
Mailing Address - Fax:
Practice Address - Street 1:7833 COROZAL DR.
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915
Practice Address - Country:US
Practice Address - Phone:915-487-2594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10723101YA0400X
TX70851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)