Provider Demographics
NPI:1831396670
Name:HASKINS, CARTER Y (PC)
Entity type:Individual
Prefix:MR
First Name:CARTER
Middle Name:Y
Last Name:HASKINS
Suffix:
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LUTHER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3130
Mailing Address - Country:US
Mailing Address - Phone:419-281-3716
Mailing Address - Fax:419-281-4605
Practice Address - Street 1:304 LUTHER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3130
Practice Address - Country:US
Practice Address - Phone:419-281-3716
Practice Address - Fax:419-281-4605
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0501103101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health