Provider Demographics
NPI:1770526253
Name:CARTER, DAVID JEFFERY (LIMHP, LPC, LMHP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JEFFERY
Last Name:CARTER
Suffix:
Gender:M
Credentials:LIMHP, LPC, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16516 LUCILLE ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-7960
Mailing Address - Country:US
Mailing Address - Phone:913-390-3172
Mailing Address - Fax:402-502-2513
Practice Address - Street 1:12022 BLUE VALLEY PKWY STE 1002
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2647
Practice Address - Country:US
Practice Address - Phone:913-390-3172
Practice Address - Fax:402-502-2513
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE179101YM0800X, 101YM0800X
NE757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE104600000Medicaid