Provider Demographics
NPI:1942517396
Name:CARTER, TUNYA TONETTE (MA, LPC, NCC)
Entity Type:Individual
Prefix:MISS
First Name:TUNYA
Middle Name:TONETTE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26336 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015-1215
Mailing Address - Country:US
Mailing Address - Phone:313-671-2555
Mailing Address - Fax:
Practice Address - Street 1:26336 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1215
Practice Address - Country:US
Practice Address - Phone:313-671-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional