Provider Demographics
NPI:1801481908
Name:CARTER, MARY ELIZABETH (MA, ALC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:MA, ALC
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, ALC
Mailing Address - Street 1:2133 KELLY LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5115
Mailing Address - Country:US
Mailing Address - Phone:205-516-0229
Mailing Address - Fax:
Practice Address - Street 1:300 OFFICE PARK DR STE 118
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2415
Practice Address - Country:US
Practice Address - Phone:205-516-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3598A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty