Provider Demographics
NPI:1134832090
Name:CARTER, KERA (LLMSW)
Entity type:Individual
Prefix:
First Name:KERA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25850 ARDEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1624
Mailing Address - Country:US
Mailing Address - Phone:313-399-9729
Mailing Address - Fax:
Practice Address - Street 1:25850 ARDEN PARK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1624
Practice Address - Country:US
Practice Address - Phone:313-399-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851100431104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker