Provider Demographics
NPI:1255575601
Name:CARTER, SUSAN (LPCC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON,
Mailing Address - Street 2:UNIVERSITY OF TOLEDO MEDICAL CENTER, DEPT OF MEDICINE
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614
Mailing Address - Country:US
Mailing Address - Phone:419-383-3913
Mailing Address - Fax:419-383-6063
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:DEPARTMENT OF MEDICINE
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3913
Practice Address - Fax:419-383-6063
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0002508101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9340243Medicaid