Provider Demographics
NPI:1457393530
Name:CARTER, DAVID DOUGLAS (LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:DOUGLAS
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 1:1419 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64503-2510
Mailing Address - Country:US
Mailing Address - Phone:816-294-6790
Mailing Address - Fax:816-364-6977
Practice Address - Street 1:1419 S 10TH ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64503-2510
Practice Address - Country:US
Practice Address - Phone:816-294-6790
Practice Address - Fax:816-364-6977
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health