Organization Name: | ANTONIA CARTER, M.A., LMHC, P.A. |
NPI Number: | 1679938583 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANTONIA CARTER (OWNER) |
Mailing Address: | 623 Oak St Green Cove Springs |
State: | FL US |
Postal Code: | 320434313 |
Phone Number: | 9045319752 |
Fax Number: | 9045315149 |
NPI Enumeration Date: | 12/18/2015 |
NPI Last Update Date: | 12/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |