Provider Demographics
NPI:1134268733
Name:CARTER, ROBERT HENRY (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HENRY
Last Name:CARTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2776
Mailing Address - Country:US
Mailing Address - Phone:573-815-0343
Mailing Address - Fax:
Practice Address - Street 1:215 S MORLEY ST
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-2243
Practice Address - Country:US
Practice Address - Phone:660-269-9577
Practice Address - Fax:660-269-9578
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001018050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health