Provider Demographics
NPI:1952152654
Name:CARTER, ELIZABETH CLAIRE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CLAIRE
Other - Last Name:SAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3227 OAK RIDGE LOOP E
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8482
Mailing Address - Country:US
Mailing Address - Phone:701-214-4427
Mailing Address - Fax:701-253-0903
Practice Address - Street 1:3227 OAK RIDGE LOOP E
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8482
Practice Address - Country:US
Practice Address - Phone:701-214-4427
Practice Address - Fax:701-253-0903
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND916-9-1-17-368101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional