Provider Demographics
NPI:1942435342
Name:CARPENTER, TWAINA MANEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TWAINA
Middle Name:MANEE
Last Name:CARPENTER
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 1:2650 JEFFERSON DAVIS HWY UNIT 2352
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-3691
Mailing Address - Country:US
Mailing Address - Phone:912-622-3000
Mailing Address - Fax:
Practice Address - Street 1:4707 STILL PL
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-3012
Practice Address - Country:US
Practice Address - Phone:912-622-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8872101YM0800X
GALPC007175101YP2500X
VA0701006579101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health