Provider Demographics
NPI:1881075455
Name:CARTER, BOBBY (LPC)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:
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 1:3805 22ND ST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1142
Mailing Address - Country:US
Mailing Address - Phone:806-773-0192
Mailing Address - Fax:806-702-8169
Practice Address - Street 1:4630 50TH ST STE 610
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3520
Practice Address - Country:US
Practice Address - Phone:806-773-0192
Practice Address - Fax:806-702-8169
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70548101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional