Provider Demographics
NPI:1831520527
Name:CARTER, TERRY (LCSW)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:CARTER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 NC HIGHWAY 66 S STE 175
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-3855
Mailing Address - Country:US
Mailing Address - Phone:336-993-6120
Mailing Address - Fax:336-992-4811
Practice Address - Street 1:1635 NC HIGHWAY 66 S STE 175
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3855
Practice Address - Country:US
Practice Address - Phone:336-993-6120
Practice Address - Fax:336-992-4811
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0081031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical