MEDICARE: MR. MICHAEL PRESTON CARTER PH.D. LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	002617	MO

General Provider Information

NPI Number	:	1114126877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL PRESTON CARTER PH.D. LPC

Provider Business Mailing Address
First Line	:	4741 CENTRAL ST
Second Line	:	SUITE 251
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-1533
Country	:	US
Telephone Number	:	816-277-4290
Fax Number	:

Provider Business Practice Location Address
First Line	:	4741 CENTRAL ST
Second Line	:	SUITE 251
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-1533
Country	:	US
Telephone Number	:	816-277-4290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/13/2007

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